Fast Five Quiz: Ankylosing Spondylitis Signs and Symptoms

Herbert S. Diamond, MD

Disclosures

February 03, 2022

Peripheral musculoskeletal involvement occurs in 30%-50% of patients with AS. Peripheral enthesitis, which is inflammation at the site of insertion of ligaments and tendons onto bone, is a common clinical feature. The most frequently involved sites include:

  • Insertion of the plantar fascia on the calcaneus or the metatarsal heads

  • Achilles tendon insertion

  • Base of the fifth metatarsal head

  • Tibial tuberosity

  • Superior and inferior poles of the patella

  • Iliac crest

Other sites of involvement include:

  • Greater trochanter

  • Ischial tuberosity

  • Costochondral junctions

  • Distal scapula

  • Lateral epicondyle

  • Distal ulna

Involvement of the temporomandibular joint occurs in approximately 10% of patients and involvement of the costovertebral and costotransverse joints can occur, leading to decreased range of motion and restriction in respiration.

Learn more about the clinical presentation of AS.

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