General symptoms include morning stiffness of more than 60 minutes, fatigue, sometimes even slightly elevated temperature, but the main initial symptom is low back pain at night and in the morning. All patients with low back pain should be questioned about a positive family history concerning rheumatic diseases, as the risk of developing this illness is higher in patients where family members already have been diagnosed with ankylosing spondylitis. This of course suggests a certain genetic disposition, especially if HLA-B27 is involved (Van der Linden SM, Valkenburg HA, De Jongh BM, Cats A). As a systemic inflammatory disease it is.
