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Clinical manifestations of ankylosing spondylitis in adults

David T Yu, MD
Astrid van Tubergen, MD, PhD
Section Editor
Joachim Sieper, MD
Deputy Editor
Paul L Romain, MD


Ankylosing spondylitis (AS), a form of spondyloarthritis (SpA), is a chronic inflammatory disease of the axial skeleton manifested by back pain and progressive stiffness of the spine; it can also involve the hips, shoulders, peripheral joints, entheses, and digits. Extraarticular manifestations, including uveitis, may also be seen in patients with AS and other forms of SpA. AS typically develops in young adults, with a peak age of onset between 20 and 30 years. The endpoint, which occurs in only a subset, is complete spinal fusion with hyperkyphosis.

The name “ankylosing spondylitis” is derived from the Greek root “ankylosis,” meaning stiffening of a joint, and “spondylos,” which refers to a vertebra. “Ankylosing spondylitis” thus refers to the inflammatory disorder associated with fibrous or bony bridging of joints in the spine, including the bridging of intervertebral discs.

The epidemiology and clinical manifestations of AS are reviewed here. The pathogenesis, classification criteria, diagnosis, and treatment of AS and other SpA in adults, and SpA in children, are discussed separately. (See "Pathogenesis of spondyloarthritis" and "Diagnosis and differential diagnosis of ankylosing spondylitis and non-radiographic axial spondyloarthritis in adults" and "Assessment and treatment of ankylosing spondylitis in adults" and "Spondyloarthropathy in children".)


Ankylosing spondylitis (AS) is the prototypic form of spondyloarthritis (SpA), a family of disorders characterized by inflammation around the entheses (the sites of ligament insertion into bone), an association with the human leukocyte antigen (HLA)-B27, and radiographic sacroiliitis.

Classically, the diseases which comprise the SpA are AS, undifferentiated SpA, reactive arthritis, psoriatic arthritis, juvenile SpA, and arthritis/spondylitis associated with inflammatory bowel diseases (IBD). (See "Reactive arthritis" and "Clinical manifestations and diagnosis of peripheral spondyloarthritis in adults" and "Clinical manifestations and diagnosis of psoriatic arthritis" and "Spondyloarthropathy in children" and "Arthritis associated with gastrointestinal disease".)


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Literature review current through: Sep 2016. | This topic last updated: Sep 28, 2015.
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