Browse
Topics & Collections
Search for a specific
disease or term
—  or  —
Learn more about ACP Smart Medicine

Dynamed

X
This content was provided by DynaMed (dynamed.ebscohost.com). For more information click here.
Last Updated: 5/13/2013  

Ankylosing Spondylitis

Diagnosis
  • Consider the diagnosis of ankylosing spondylitis at any age in patients with chronic inflammatory back pain and decreased spinal mobility.

  • Ask about symptoms of spondyloarthropathy in patients with predisposing comorbid conditions such as inflammatory bowel disease and other forms of inflammatory arthritis.

  • Evaluate patients with suspected ankylosing spondylitis for limited mobility of the spine, limited chest expansion, or both.

  • Perform a plain radiograph of the pelvis to look for sacroiliitis in patients with suspected ankylosing spondylitis and consider MRI in unclear cases.

  • Consider testing for HLA-B27 and markers of inflammation in patients with intermediate probability of ankylosing spondylitis.

  • Use validated criteria such as the Modified New York Criteria or the ASAS Criteria to make the diagnosis.

Therapy
  • Use an NSAID as first-line drug therapy to relieve pain and stiffness and to improve or maintain physical function.

  • Institute a program of regular exercise and or physical therapy in managing patients with ankylosing spondylitis.

  • Consider intra-articular corticosteroids in patients with ankylosing spondylitis; do not use traditional disease-modifying agents.

  • Treat patients with TNF-α blockers (infliximab, etanercept, adalimumab, or golimumab) when the disease cannot be well managed with conventional therapy.

DOI: 10.7326/d211
The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP.
Disclosures:
Muhammad Asim Khan, MD, MACP, FRCP is a consultant for Abbott and Genentech, and received honoraria from Abbott, Amgen, Genentech, and Pfizer. Muhammad Asim Khan, MD, MACP, FRCP is a consultant for Abbott and Genentech, and received honoraria from Abbott, Amgen, Genentech, and Pfizer. Salih Ozgocmen, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Deborah Korenstein, MD, FACP, Editor in Chief, ACP Smart Medicine, has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Richard B. Lynn, MD, FACP, Editor, ACP Smart Medicine, has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
Related Content
Annals of Internal Medicine