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Ankylosing spondylitis presenting as shoulder pain in an athlete

Ankylosing spondylitis is a disease characterized by inflammation of the spine’s joints, often resulting in bony ankylosis. The classic clinical presentation of ankylosing spondylitis occurs in the late adolescent or young adult male with persistent low back pain. Most symptoms are localized to the lumbrosacral region, with pain and stiffness often worse during inactivity and better with activity. But, despite its classic presentation, ankylosing spondylitis can range from full-blown spinal inflammation with the roentgenographic &dquo;bamboo spine&dquo; to various atypical syndromes in which the axial involvement may be relatively inconspicuous. Though ankylosing spondylitis is known and named for spinal involvement, it can initially involve a peripheral joint. This paper describes a young athlete whose initial presentation involved his shoulder.