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. If you want to follow along with written notes on this

topic, you can follow along at zero definals.com slash ankylosing spondylitis or in the rheumatology section of the zero definals medicine book. Let's get straight into it.

Ankylosing spondylitis is an inflammatory condition that mainly affects the spine that causes

progressive stiffness and pain. It's part of the serengative spondolo-arthropathy group of conditions

that are related to the HLA B-27 gene.

And other conditions in this group are things like reactive arthritis

and psoriotic arthritis.

The key joints that are affected in ankylosing spondylitis are the

sacrilyac joints and the joints of the vertebral column. And the inflammation causes pain and

stiffness in these joints and it can progress to fusion of the joints. So fusion of the spinal column and the sacrioleic joints.

Fusion of the spine leads to the classical finding on the x-ray of a bamboo spine,

and this is something that will often appear in your medical exams.

There's a strong link with the HLAB27 gene, and around 90% of patients who

have ankylosing spondylitis will have this HLA B27 gene. However, only around 2% of people

who have the gene will develop anclosing spondylitis. This number goes up to around 20% if they have a first

degree relative that's affected. So if you have a first degree relative and the HLAB27 gene, there's

around a 20% chance of developing the condition. So how do these patients present? The typical presentation, especially in your exams,

is a young adult male in their late teens or 20s, and affects males about three times more

often than females, and symptoms usually develop gradually over more than three months.

The main presenting features are low back pain and stiffness and sacro-yleac pain,

which occurs in the buttock region.

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