MSK-22 · Spondyloarthropathies and Fibromyalgia

Spondyloarthropathies and Fibromyalgia. Part of the Musculoskeletal series of the Reflex PM&R Board Review podcast. Audio corrections: (1) In the audio: Then they measure exactly 10 centimeters straight up the spine and make a second mark... It should increase by at least five centimeters. So from 10 to at least 15. — Correct: The audio names the modified Schober test but describes the original. The modified test marks 10 cm above and 5 cm below the lumbosacral junction, a 15 cm span, and a normal spine lengthens it by more than 5 cm, to 20 cm or more. The positive threshold, a gain under 5 cm, is the same in both versions, so a stem quoting 15 cm increasing to 19 cm describes a restricted spine. (2) In the audio: A normal difference is greater than five centimeters. Less than five means the ribs are locked in place. — Correct: Chest expansion is graded, not pass-fail at 5 cm. Roughly 5 cm or more is the usual normal, a value just under 5 cm is reduced but nonspecific and is common in healthy older adults, and a value below 2.5 cm is the classic threshold for costovertebral involvement. (3) In the audio: Anterior uveitis, or iritis, affects roughly 25% to 30% of AS patients. — Correct: Acute anterior uveitis occurs in approximately one third of ankylosing spondylitis patients (about 33 percent in the largest pooled systematic review), with higher rates in HLA-B27-positive patients. The written chapter is correct. Full correction register: https://www.reflexpmr.com/errata. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/MSK-22.