What physical exam finding might suggest a patient has ankylosing spondylitis?

Ankylosing spondylitis (AS) is a type of inflammatory arthritis primarily affecting the spine and the sacroiliac joints, leading to various physical exam findings. One of the hallmark features of this condition is decreased spinal mobility. Patients typically experience stiffness in the spine, especially in the morning or after periods of inactivity, and this can lead to a reduced range of motion in the lumbar spine and thoracic spine.

During a physical examination, a clinician may assess spinal mobility through various maneuvers, such as measuring the distance between the wall and the occiput when the patient tries to stand against the wall or assessing the ability to flex forward. A significant limitation in these movements can indicate ankylosing spondylitis.

This finding is particularly relevant in the context of ankylosing spondylitis as it reflects the underlying pathophysiological changes associated with the condition, such as inflammation and eventual fusion of the vertebrae. Recognizing decreased spinal mobility can prompt further evaluation and imaging studies, leading to an accurate diagnosis and appropriate management plan for the patient.