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Can just upper back pain indicate ankylosing spondylitis ?

can only upper back pain and chest stiffness and mild breathing difficulty be a sign of AS. no lower back pain . HLA B 27 positive. RA negative. uric acid normal. hb 13.1. age 37. male. pain for last 10 months. mri, x rays normal. esr , crp normal. weight 70.5 kg. height 5 8 . not taking any medicine despite nsaid and muscle relaxant prescriptions. stiffness between shoulder blades always there on getting up after lying down for 5 minutes or more. but no pain while i am lying down. feel it only after getting up and pulling shoulders back. sometimes feel feverish and kind of unwell. dizziness also and kind of weak feeling in right arm. strength and all is ok...but its a feeling of weakness. what could this be? i am tired of confusing diagnosis and this sick feeling.
Asked On : Mon, 11 Apr 2011
Answers:  1 Views:  366
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General & Family Physician 's  Response
Ankylosing Spondylitis commonly occurs in males between 20-40. Co-relation with HLA B27 is strong. I is an auto-immune disorder. For diagnosis CT Scan / MRI can be done for upper lumbar vertebrae. Also Antineutrophil cytoplasmic antibodies, Tumor necrosis factor-alpha (TNF α) and IL-1 are important diagnostic tools.
Your breathlessness may be because of apical lung fibrosis which can be checked by CT / MRI.
Schober's test can be done to note the normal increase in the distance between two fixed point while flexion of spine as compared to during straight / erect position.
Ankylosing spondylitis is sero-negative spondyloarthropathies, where RA factor would be negative.
Answered: Mon, 11 Apr 2011
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