Ankylosing Spondylitis

Many of the patients that are evaluated in the military medical treatment facilities have musculoskeletal complaints. One of the most common chief complaints amongst active duty personnel is back pain. Electronics Technician Second Class Petty Officer Michael Jones had an appointment with Dr. Andrews and myself for the evaluation of chronic back pain at the Regional Support Organization, Norfolk, Virginia.

Michael is a 29 year-old black male that at times finds it necessary to call his roommate for help getting out of bed in the morning. He reveals that it is because of pain and stiffness in his spine and hip area. Michael's back pain has been increasing in severity for the past six months. He finds it difficult to perform certain movements that he could carry out in the past. The pain is at its worst in the morning and more frequently, he has trouble getting out of bed without some assistance. Michael describes the pain as a dull and achy pain that is intermittent. In the morning his pain is at its peak and is a 7 on a pain scale of 1-10. He presents with severe pain in his spinal area and complains of stiffness and recent inability to play basketball with his friends on the weekend.

Michael suffers from an onset of burning pain in his feet later in the afternoon. He has had symptoms of back pain accompanied by stiffness for at least four years, which has progressively worsened with time. While his joints do not feel unusually warm or swollen, he states that there is no evidence of any erythema to his joints. There is no recollection of any popping or clicking noises upon movement of his joints. Michael does report that his joints feel stiff and that the stiffness limits his mobility. He has also commented that after a long period of sitting at his computer, when he rises from the seated position he feels pain in his hips. Michael denies any sprains, paresthesias or deformities. Although Michael does report muscle tenderness, some left hip...