Ankylosing spondylitis (seronegative spondyloarthropathy)

HIGH-YIELD Appears 3×

Teaching point

Inflammatory back pain (worse with rest/morning, improves with exercise) in a young man, HLA-B27 associated, with sacroiliitis, possibly anterior uveitis or aortic regurgitation, is ankylosing spondylitis. First-line treatment is an NSAID (e.g. ibuprofen); biologics (TNF/IL-17 inhibitors) if NSAIDs fail. Methotrexate does not help axial disease.

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