Ankylosing Spondylitis

Young male pt with h/o acute anterior uveitis, aortic regurgitation, restrictive lung disease, IgA nephropathy presents with low back pain/stiffness for > 3 months. Pain improves with exercise/activity. Decreased chest expansion and reduced range of lumbar spine forward flexion on Schober testing.

• Evidence of sacroiliitis on anteroposterior and lateral x-ray

• Obtain HLA B27 assay

• X-ray of anteroposterior/lateral lumbar spine, lateral c-spine, and pelvis in 3 months to monitor disease progression

• Start NSAIDs

• Pt advised to engage in regular aerobic exercise