Серонегативные спондилоартриты: воспалительная боль в спине и HLA-B27 — видео из блокнота

A marching band director has been told three times his back is fine, but he wakes at four in the morning and once had a flaring red eye. A resident reasons through this case on teaching rounds. What you'll learn: • How to separate inflammatory from mechanical back pain using IPAIN at the bedside • Why the enthesis, not the synovium, is the primary lesion in axial spondyloarthritis • The pathway from osteitis and erosion to syndesmophyte and bamboo spine • What HLA-B27 actually adds, and why it is never a screening test in undifferentiated back pain • Two bedside numbers, modified Schober and occiput-to-wall, and when to move from plain film to MRI Key takeaway: You cannot reverse a fused spine, only prevent one, so the workup starts the day the pattern is recognized. ⏱ Chapters: 0:00 Introduction 1:15 Teodor's night pain and forgotten uveitis 3:31 Tender entheses and a flattened spine 5:04 From enthesitis to the bamboo spine 6:46 Ruling out mechanical, disc and infection 8:19 IPAIN and the HLA-B27 numbers 9:40 Schober test and MRI over plain film 11:14 Lucian's mechanical mirror image Part of Teaching Service — Hospital Rounds: education for residents and advanced practice providers. For clinician and trainee education only. Not medical advice; verify against current guidelines and institutional protocols before applying to patient care. #AxialSpondyloarthritis #HLAB27 #InflammatoryBackPain #CaseStudy #Rheumatology #AnkylosingSpondylitis #MedEd #ResidentEducation #InternalMedicine #ClinicalReasoning