Spondyloarthritis refers to a group of inflammatory diseases characterized by spinal & joint oligoarthritis, enthesitis, and sometimes mucocutaneous, ocular and/or cardiac manifestations.
Ankylosing spondylitis is a prototype of spondyloarthritis, particularly of the axial form.
Diagnosis of ankylosing spondylitis is definite if any of the radiological criterion (grade≥2 bilateral sacroiliitis or grade ≥3 unilateral sacroiliitis) is associated with at least one of the clinical criterion (low back pain & stiffness for >3 months that improves with exercise but not relieved by rest, limitation of motion of the lumbar spine in the sagittal and frontal planes, limitation of chest expansion relative to normal values correlated for age and gender.

Follow Up

  • Follow-up schedule depends on the patient’s disease activity
    • Annual clinic visits is recommended for patients with stable ankylosing spondylitis (AS)
  • At least 1 assessment tool should be used during clinic visits, depending on the disease activity
    • Erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) monitoring at regular intervals is recommended
    • Dual x-ray absorptiometry (DXA) scanning of the spine may be considered for patients at high risk for osteoporosis or osteopenia
  • Referral to an ophthalmologist is recommended for ankylosing spondylitis (AS) patients with acute iritis
  • For patients with stable ankylosing spondylitis (AS) given combination therapy with non-steroidal anti-inflammatory drugs (NSAIDs) and tumor necrosis factor (TNF) inhibitor upon diagnosis, patients may continue using tumor necrosis factor (TNF) inhibitor alone as maintenance therapy
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