Individuals typically complain of a gradual start of lower back pain and associated muscle seizures experienced for several months. The pain is usually described as worse in the morning and improving during the day. Individuals may also report pain and stiffness of the rib cage and/or pain beginning in the larger peripheral joints (e.g., knees, hips, shoulders). Eye pain, loss of appetite, weight loss, and fatigue may be reported.

Physical exam may reveal painfulness over the area where the sacrum and hipbones meet (sacroiliac joints) and lumbar range of motion may be decreased. Chest expansion may be decreased to well below the 2 inch (5 cm). Evidence of eye inflammation (iritis) may be observed. Peripheral joints will be evaluated for tenderness, swelling, and restricted motion.

You’ll probably have one or more of these tests:

  • C-reactive protein (CRP)
  • erythrocyte sedimentation rate (ESR)
  • plasma viscosity (PV).

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