Musculoskeletal · UKMLA & AKT
Ankylosing spondylitis
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise ankylosing spondylitis — the full SA Note notes add investigations, management, complications and 10 practice questions.
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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