Ankylosing spondylitis is a chronic progressive disease that primarily affects the sacroiliac joints, spinal prominences, paraspinal soft tissues and peripheral joints, and may be accompanied by extra-articular manifestations. In severe cases, spinal deformities and joint ankylosis may occur. The onset of the disease is insidious. Patients gradually develop pain or stiffness in the low back or sacroiliac region, waking up in the middle of the night with pain, difficulty turning over, and stiffness in the low back when rising in the morning or after sitting for a long time, but it is relieved after activity. Some patients feel dull pain in the buttocks or severe pain in the sacroiliac region, which occasionally radiates to the periphery. The pain can be aggravated by coughing, sneezing, or sudden twisting of the back. In the early stage of the disease, the pain is mostly intermittent on one side, and after a few months, the pain is mostly persistent bilaterally. As the disease progresses from the lumbar spine to the thoracic and cervical spine, pain, restricted movement or spinal deformity occurs in the corresponding area. It has been reported that about 45% of patients in China start with peripheral arthritis. 24-75% of patients develop peripheral arthropathy at the beginning or during the course of the disease, with the knee, hip, ankle and shoulder joints being the majority, while the elbow and small joints of the hand and foot are occasionally involved. Asymmetric, few-joint or single-joint arthritis and arthritis of the large joints of the lower extremities are the characteristics of peripheral arthritis in this disease. In our patients, arthritis or arthralgia of the knee and other joints, except the hip, is mostly transient and rarely or hardly causes joint destruction and disability. The hip joint is involved in 38-66% of the cases, showing localized pain, restricted movement, flexion-twisting and joint ankylosis, most of which are bilateral, and 94% of the hip symptoms start within the first 5 years after the onset of the disease. The disease is more likely to occur at a younger age and in those with peripheral joint disease. The systemic manifestations of the disease are mild, with a few severe cases having fever, fatigue, wasting, anemia, or other organ involvement. Metatarsal fasciitis, Achilles tendinitis, and other areas of tendinopathy are common in this disease. 1/4 of patients develop uveitis during the course of the disease, alternating unilaterally or bilaterally, which usually resolves spontaneously and can lead to visual impairment with repeated attacks. Neurological symptoms arise from compressive spinal neuritis or sciatica, vertebral fractures or incomplete dislocations, and cauda equina syndrome, the latter of which can cause impotence, nocturnal incontinence, bladder and rectal dullness, and loss of ankle reflexes. Very few patients develop fibrosis of the upper lobe of the lung. It is sometimes accompanied by cavity formation and is considered tuberculosis, and can be exacerbated by concurrent mycobacterial infections. It can be complicated by IgA nephropathy and amyloidosis.