Photograph of a young man suffering from severe ankylosing spondylitis, showing kyphosis (outward curvature) of the spine due to fusion of the vertebrae. Ankylosing spondylitis is a rheumatic disease involving the spinal synovial joints and the sacro-iliac joints that connect the sacral spine to the pelvis. Inflammation typically begins in the sacro-iliac joints or lumbar spine, & may progress up the entire spine. Shoulders and hips may also be affected. Pain and stiffness are treated with anti-inflammatory drugs (ibuprofen, piroxicam) and through physiotherapy, which attempts to preserve spinal mobility.