How to manage ankylosing spondylitis

doi:10.1136/bmj.333.7568.0

BMJ 2006;333 (16 September), doi:10.1136/bmj.333.7568.0

How to manage ankylosing spondylitis

Early diagnosis of ankylosing spondylitis can be difficult butis important for its treatment, say McVeigh and Cairns (p 581).This clinical review discusses how this chronic inflammatoryrheumatic disorder, which primarily affects the axial skeleton,is diagnosed using history, examination, genetics, laboratoryfindings, and imaging. The authors describe traditional treatment,which begins with physiotherapy and non-steroidal anti-inflammatorydrugs. They also outline why and how tumour necrosis factorinhibitors have revolutionised the treatment of ankylosing spondylitis—andthe problems associated with this approach.