How to diagnose association of Ankylosing Spondylitis and Rh
Case Report
A 21-year-old female, had a 1-year history of pain in the lumbosacral area, in the Achilles tendon at the back of the ankle, and metatarsal pain, which had been exacerbated for 2 months. The patient felt pain and hard to turned the body over at night, but the pain could be softened after activation in the morning. She underwent a physical examination on hospital admission. Her general health and auscultation of the heart and lungs were normal. Swelling and tenderness in the joints of the four limbs was not observed. The Patrick’s test and the Schober test were positive. Laboratory examinations were shown in Table 1. X-ray of the lumbosacral area showed grade 3 bilateral sacroiliitis (Figure 1). There was no obvious X-ray change in the joints of both hands and forefoot. By evaluation of symptoms and signs as well as radiological examination, our diagnosis was AS given the presence of two clinical criteria in association with the radiological criterion per the modified New York criteria for ankylosing spondylitis. She was given indomethacin 100 mg per day as symptomatic treatment, and DMARDs (Sulfasalazine 2 g per day) to control the disease.

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