How are clinical features of SpA?

Inflammatory back pain (IBP, first manifestation 75% of axSpA, lumbosacral junction, inactivity aggrevates and NSAIDs relieve, prolonged morning stiffness (>30min), nocturnal pain wakening, sacroilitis/spondylitis dx by expert criteria 4/5 improve w/exercise, pain at night, insidious onset, age <40, no improvement with rest) Ankylosis (Ossification of ligaments, costovertebral, sternocostal joints. Loss of lumbar lordosis, thoracic hyperkyphosis, forward stooping of neck, restricted spinal movement muscle spasms, respiratory failure decreased vital capacity and increased residual if hip involved we have bending forward) Osteoporosis fracture (spinal osteoporosis increase risk of fracture with lack of mobility and inflammatory cytokines, IBD higher risk) Peripheral Arthritis (Assymetric, oligoarticular, lower limbs, mechanical microtrauma, upper limb if PsA bilateral symmetrical polyarticular presentation. DIP joints see dactylitis sausage fingers)) Dactylitis (Very characteristic, ReA, PsA and undiff., sausage fingers/toes due to synovitis, enthesis, tenosynovitis, soft tissue swelling) Anterior chest wall pain (axial, 15% of pt, stero/clav/manubr, reduced chest expansion, can involve hips more than shoulders see hip pain, early bilateral for juvenile destruction and disability