Rheumatologic Disorders Practice Test

The key idea is that ankylosing spondylitis is diagnosed mainly from the clinical pattern of inflammatory back pain seen in history and on physical examination. Inflammatory back pain typically starts before age 40, is chronic, improves with exercise, does not improve with rest, and is accompanied by significant morning stiffness. When these clinical features are present and spinal mobility is reduced with tenderness at the Sacroiliac joints, the diagnosis is supported even before imaging shows structural changes. X-ray findings like bamboo spine or squared-off vertebrae reflect late, established disease and may be normal early on, so they are not the primary basis for diagnosis. Imaging and tests such as MRI or HLA-B27 positivity can help confirm or support the diagnosis, but they don’t replace the central role of the history and exam.