Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about ankylosing spondylitis. And you can find written notes on this topic at

zero definals.com slash ankylosing spondylitis or in the rheumatology section of the zero definals medicine book.

So let's get straight into it.

Ankylosing spondylitis is an inflammatory condition affecting the axial skeleton,

mainly the spine and the sacro-eiliac joints, causing progressive stiffness and pain.

It's also known as axial spondoloarthritis.

It's part of the seronegative spondolo-arthropathy group of conditions

that also includes psoriatic arthritis and reactive arthritis.

The main affected joints are the sacro-yleac joints and the vertebral column joints. Inflammation causes pain and stiffness in these joints.

It can progress to spine and sacro-Iliac joint fusion in advanced disease.

There's a strong link with the HLA B-27 gene, and around 90% of patients with ankylosing spondylitis

have this HLA B-27 gene. It's thought that less than 10% of people who have the gene

will go on to get ankylosing spondylitis.

The condition is more common in men, but women can also be affected.

Let's talk about the presentation. The typical presentation is a young adult male in their

20s. Symptoms develop gradually over at least three months. The main

presenting features are pain and stiffness in the lower back and sacro-yleac joint pain in the

buttoe region. The pain and stiffness is worse with rest and improves with movement.

The pain worsens at night time and in the morning and it may wake them up from sleep.

Patients will wake up with stiffness that takes at least 30 minutes to improve once they get moving.

Additional symptoms and problems include chest pain related to the costo-vertebral and

...