Information ⬇
- Back pain and stiffness: not relieved by lying down, often present at night forcing pt to leave bed, worse in the morning, improves with activity, insidious onset, duration >3 months (often called symptoms of “inflammatory” back pain).
- Extra-axial arthritis: hip and shoulders 25-35%, other peripheral joint involvement up to 30%, usually asymmetric.
- Chest pain: from involvement of thoracic skeleton and muscular insertions.
- Extra/juxta-articular pain: due to “enthesitis”: inflammation at insertion of tendons and ligaments into bone; frequently affects greater trochanter, iliac crests, ischial tuberosities, tibial tubercles, heels.
- Extra-articular findings—include acute anterior uveitis in up to 40% of pts, aortitis, aortic insufficiency, GI inflammation, cardiac conduction defects, amyloidosis, bilateral upper lobe pulmonary fibrosis.
- Constitutional symptoms: fever, fatigue, weight loss may occur.
- Neurologic complications: related to spinal fracture/dislocation (can occur with even minor trauma), atlantoaxial subluxation (can lead to spinal cord compression), cauda equina syndrome.
Outline ⬆