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Articular manifestations

Authoring team

The articular manifestations of ankylosing spondylitis include:

  • backache and stiffness usually worse after inactivity or on waking in the morning
  • back pain is usually initially in the lumbar region and then progresses to the thoracic region pain
  • 10% of cases have swollen and tender peripheral joints
  • all movements of the spine are reduced, especially extension, resulting in:
    • failure to obliterate lumbar lordosis on forward flexion
    • chest expansion of less than 5 cm
    • complete rigidity due to ankylosis
  • painful heels and tenderness at the site of insertion of the achilles tendon - achilles tendinitis
  • pain over the iliac crest
  • atlanto-axial subluxation
  • osteoporosis
  • in children a lower limb oligoarthritis usually precedes spinal involvement

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