S

pondy
li
ti
s

S
pondyl
i
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ckpa
ina
ndi
ses
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ial
l
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esul
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n
i
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ert
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.
the
rear
ethre
emaint
ypeofspondyl
i
tis
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rvi
cal
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li
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s-whi
cha
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t
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owardst
heba c
kofthenec
k

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umba
rspondy
li
ti
s–whi
chc
aus
est
hepa
ini
nthel
umba
rre
gion

•Ank
ylos
ings
pondyl
i
tis-whi
chi
spri
mar
il
yadi
sea
set
hata
ffe
ctst
hes
acr
oil
i
acj
oi
nts
,ca
usi
ngs
ti
ff
nes
sin
thel
owerbac
k,hi
ps,kneesa
ndches
t

Et
iol
ogy

.
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aus
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enet
ic
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ayak
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olei
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sea
se.

.
HLA-B27li
kel
yaccountsf
orabout30pe
rcentoft
heov
era
llr
is
k,butt
her
ear
enumer
ousot
herg
ene
s
work
inginconce
rtwithHLA-
B27.

S
IGNANDS
YMPT
OMS

.
Pai
nands
ti
ff
nes
sint
hel
owerba
cka
ndbut
toc
ks

.
thepa
ini
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landdi
ff
use
dra
the
rtha
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ali
zed

.
i
twor
sesi
nthemor
ninga
ndt
heni
ghta
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inge
xer
cis
e

.
othe
rsy
mpt
omsi
ncl
ude-
bowe
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tion

.
uvei
ti
s

Phy
sic
alEx
ami
nat
ion

T
heov
era
llpoi
ntst
ake
nint
oac
countwhe
nma
kinga
nASdi
agnos
isa
re:

•
Ons
eti
sus
ual
l
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r45y
ear
sofa
ge.

•
Pai
npe
rsi
st
sformor
etha
nthr
eemont
hs(
i.
e.,
iti
schr
oni
c)
.

•
Bac
kpa
ina
nds
ti
ff
nes
swor
senwi
thi
mmobi
l
ity
,es
pec
ial
l
yatni
ghta
ndea
rlymor
ning
.

•
Bac
kpa
ina
nds
ti
ff
nes
stendt
oea
sewi
thphy
sic
ala
cti
vi
tya
ndex
erc
ise
.
MANAGEMENT

.
Nons
ter
oida
lant
i-
inf
lamma
tor
ydr
ugs(
NSAI
Ds)NS
AIDs

.
Ana
lge
sic
sAc
eta
minophe
nandopi
oi
d-(
li
ke)a
gent
sar
eof
tenus
ed

.
Dis
eas
e-modi
fy
inga
nti
-r
heuma
ticdr
ugs(
DMARDs
)

PHY
SIOT
HERAPYMANAGE
MENT

.
st
reng
the
ningt
hec
oremus
clesa
nds
pine,

.
i
ncr
eas
ingt
her
ang
eofmot
iont
hroug
hmobi
l
itye
xer
cis
es

.
Regul
arpr
acti
ceoft
heseanky
los
ings
pondy
li
ti
sex
erc
ise
sisc
ruc
ial
toa
tta
ini
ngt
hebenef
it
sof
a
nky
losi
ngspondy
li
ti
sphys
iot
hera
py.