Faculty Opinions recommendation of Serum monocyte chemotactic protein-1 concentrations distinguish patients with ankylosing spondylitis from patients with mechanical low back pain.

We presented a case of 45 years old unmarried woman who complaints of chronic low back pain and diagnosed as a case of Osteitis CondensansIlii (OCI). We are discussing this rare presentation of OCI to increase awareness among the specialty and primary care physicians, as it may be confused with other conditions like- Ankylosing Spondylitis (AS) and inflammatory arthritis. It also prevents misdiagnosis and extensive investigations that not only increase anxiety but are of little benefit.Medicine Today 2016 Vol.28(2): 89-91

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Diagnosis of Ankylosing Spondylitis: Do not let the spine bites the eye

Malaysian Family Physician ◽

10.51866/cr1121 ◽

2021 ◽

Vol 16 (2) ◽

pp. 73-77

Author(s):

Chia Chee Chew ◽

Ju Juen Chin ◽

Wan Hazabbah Wan Hitam ◽

Mei Fong Chong ◽

Liza-Sharmini Ahmad Tajudin

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Ankylosing Spondylitis ◽

Young Adult ◽

Anterior Uveitis ◽

Case Series ◽

Topical Steroids ◽

Initial Symptom ◽

Low Back ◽

Acute Anterior Uveitis

Background: A diagnosis of ankylosing spondylitis (AS) is challenging and often delayed despitebpatients being symptomatic. Low back pain is the most common initial symptom, appearing in the second and third decades of life. Acute anterior uveitis (AAU) occurs much later in the course of the disease, often when the destruction of the spine is already debilitating. Objective: Here, we report three cases of AS that were diagnosed after the patients developed AAU. Methods: A case series illustrated AAU leading to the diagnosis of AS years after the initial episode of low back pain. A comparison of the clinical presentation, diagnosis, and outcomes was also illustrated. Result: We report three cases of acute anterior uveitis (AAU)-associated AS diagnosed only after many visits to the primary health care provider with the complaint of chronic low back pain. All three patients had irreversible radiological changes upon diagnosis of AS. The AAU resolved with topical steroids, and one patient developed cataract. Conclusion: A high index of suspicion of AS in a young adult with chronic back pain before the development of AAU may prevent further functional loss and provide a better prognosis. Diagnosis of AS following AAU is not only associated with dependency but also may rob the vision of a young adult.

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Comparison of Pain Location and Extent Between Adults with Ankylosing Spondylitis-related Inflammatory versus Chronic Nonspecific Low Back Pain

Journal of Spine Practice (JSP) ◽

10.18502/jsp.v1i1.9777 ◽

2021 ◽

pp. 17

Author(s):

Lolwah AlRashed AlHumaid

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Ankylosing Spondylitis ◽

Disease Activity ◽

Self Efficacy ◽

The Body ◽

Lumbar Region ◽

Low Back ◽

Pain Location ◽

Pain Extent

Introduction: Pain among adults with ankylosing spondylitis-related inflammatory low back pain (AS-ILBP) is not well-characterized, and individuals with AS-ILBP are frequently misdiagnosed with chronic nonspecific low back pain (CNSLBP). This study digitally quantifies and compares the location and extent of pain between adults with AS-ILBP and those with CNSLBP and examines the relationship between the pain extent and functional, psychological, and condition-specific factors in those with AS-ILBP. Methodology: The location and extent of pain in adults with AS-ILBP (n = 27) or CNSLBP (n = 22) was quantified using a digital pain drawing analysis. Relationships between pain extent and perceived pain intensity and disability, pain-related cognitive factors (back beliefs, fear of movement, pain catastrophizing, pain coping, and self-efficacy), psychological distress, and AS-specific features were examined in those with AS-ILBP. Result: Pain extent in the dorsal region of the body was greater in those with AS-ILBP than in CNSLBP (P < 0.05). In AS-ILBP, the most prevalent pain location was the lumbar region (88.9%), followed by the buttock (70.4%); the frequencies of reported pain in these regions were similar between groups (P > 0.05). The AS-ILBP group more frequently reported pain in the thoracic (70.4%) and cervical (51.8%) regions (P < 0.05). In the AS-ILBP group, larger pain extent was moderately associated with negative back beliefs (rs = –0.44 to –0.41, P < 0.05) and lower self-efficacy (rs = –0.58 to –0.42, P < 0.05), but not with any of functional outcomes. Larger pain extent was associated with higher disease activity (P < 0.05). Conclusion: Adults with AS-ILBP perceive larger pain extent in spinal regions and the degree of pain extent is associated with negative back beliefs, lower self-efficacy, and higher disease activity. Pain drawings may assist in the differential diagnosis of CNSLBP and AS-ILBP. Further, they may aid psychological screening in adults with AS-ILBP.

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