Ankylosing spondylitis diagnosis and differential diagnosis

1. Common diagnosis in 1984 to amend the New York standard. Its contents include: (1) Clinical criteria: ① low back pain, Chen Jiang for more than 3 months, the activities of improvement, no improvement in income; ② of lumbar-surface and sagittal restricted activities; ③ thorax activities for less than the corresponding age, sex, the normal people. (2) radiology standards: sacroiliac arthritis, bilateral or unilateral ≥ Ⅱ-grade Ⅲ ~ Ⅳ. Ⅱ for mildly abnormal level, the limitations of that erosion, sclerosis, but the gap joints are normal. Ⅲ level is obvious anomaly, erosion, sclerosis, or narrow joint space widened, and some, such as a tonic (or more) to change. Ⅳ level is a serious anomaly, namely, complete ankylosis. (3) Diagnosis: Yes ankylosing spondylitis: the radiology and a standard (and above) clinical standards. May ankylosing spondylitis: with three clinical standards, or to meet with radiology standards without any clinical standards. 2. Differential diagnosis with mechanical low back pain, diffuse idiopathic bone hyperplasia identification. Early, especially in peripheral arthritis as the first symptoms of rheumatoid arthritis should be identified. But also with other spondylarthropathies identification. Juvenile onset of ankylosing spondylitis, waist, back pain and other symptoms rare joint axis. Because of immature bones, pelvic films in the early diagnosis of osteoarthritis of the sacroiliac little help. Spine is a tonic in arthritis, attachment points and so there many years later. In fact most of retrospective diagnosis, with juvenile rheumatoid arthritis, juvenile lupus erythematosus identification. Late onset of ankylosing spondylitis at the onset of spinal symptoms or absence of light, a small number of joint arthritis and light, ESR by fast, can have lower limb pitting edema, and seronegative synovitis identification. The latter is common in the age of 50 after the crowd, but the prognosis is good. Late onset of ankylosing spondylitis, a few years after the sacroiliac arthritis and spinal involvement, and non-steroidal anti-inflammatory drugs efficacy poor.