Musculoskeletal · UKMLA & AKT
Ankylosing spondylitis
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Inflammatory back pain - insidious onset, morning stiffness >60 min, improves with exercise (not rest), night pain waking in early hours
- Peak onset age 15-35; male predominance (~3:1); HLA-B27 positive in ~90%
- Reduced lateral flexion - earliest spinal movement lost; also reduced rotation
- Classic posture - loss of lumbar lordosis, accentuated thoracic kyphosis, cervical flexion deformity ('question mark posture')
- Schober's test - mark L5 and 10 cm above; increase <5 cm on maximal forward flexion = restricted
- Anterior uveitis (iritis) - most common extra-articular feature (~40%); acute painful red eye with photophobia
- Apical pulmonary fibrosis - upper lobe fibrosis in late disease; visible on CXR
- Aortic regurgitation - from aortitis; early diastolic murmur
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