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Ankylosing Spondylitis

Ankylosing Spondylitis is a topic covered in the 5-Minute Emergency Consult.

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  • Chronic inflammatory disease, primarily affects the axial skeleton with predilection toward the spine and sacroiliac (SI) joints:
    • SI joints 100%
    • Cervical spine 75%
    • Thoracic spine 70%
    • LS spine 50%
    • Hip joints 30%
    • Shoulder joints 30%
  • Spondylitis (inflammation of vertebrae) of ankylosing spondylitis (AS) begins at the insertions of the outer fibers of the annulus fibrosus (enthesitis) of the vertebrae:
    • Ossification (syndesmophyte formation) may lead to complete fusion, ankylosis, of the vertebrae.
    • Extensive spinal involvement causes the radiographic appearance of the brittle “bamboo spine.”
  • Onset 15–35 yr of age
  • Male to female ratio is between 2:1 and 3:1.

AS patients are at 4 times the risk for fracture and paralysis compared to the general population. They are 11 times more likely to have spinal cord injuries.

Risk Factors

Strong genetic component. HLA-B27 is present in 80–90% of patients with AS.


Disease is likely triggered by environmental factors such as infection in genetically predisposed individuals.

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Rosen, Peter, et al., editors. "Ankylosing Spondylitis." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307419/0/Ankylosing_Spondylitis.
Ankylosing Spondylitis. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307419/0/Ankylosing_Spondylitis. Accessed June 20, 2019.
Ankylosing Spondylitis. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307419/0/Ankylosing_Spondylitis
Ankylosing Spondylitis [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 June 20]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307419/0/Ankylosing_Spondylitis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Ankylosing Spondylitis ID - 307419 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307419/0/Ankylosing_Spondylitis PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -