Early treatment is an important part of keeping ankylosing spondylitis under control. The sooner the condition is diagnosed and treated, the more effective treatment measures can be in managing it.
But unfortunately—for a number of reasons—ankylosing spondylitis is difficult to diagnose and is often misdiagnosed initially. This is why it’s important to know what a physician will look for during the diagnostic process, and how you can help.
How ankylosing spondylitis is identified
Ankylosing spondylitis often manifests first in hip and low back pain, because the first joints affected are usually the sacroiliac (SI) joints, which join the base of the spine to the pelvis. But low back pain is a nonspecific symptom, caused by many spinal conditions.
There are some symptoms and characteristics of ankylosing spondylitis that can make it easier to detect:
- The condition is most often diagnosed in young men in their teens and 20s
- The pain improves with exercise and gets worse with rest
- Symptoms may include pain in the neck or other peripheral joints (more common in women with the condition)
- The condition is often accompanied by chronic fatigue
Since physical evidence of ankylosing spondylitis is often not detectable on X-rays until the condition is more advanced, doctors will rely on a patient’s history, physical exam, and blood tests to diagnose the condition.
Via blood test, the doctor may test for:
- C-reactive protein, which indicates an inflammatory marker in the body
- Erythrocyte sedimentation rate, which also screens for inflammation
- HLA-B27 gene, which a majority of people with ankylosing spondylitis carry
- Rheumatoid factor, a protein found in high level for people with other inflammatory conditions like rheumatoid arthritis or lupus, but not in those with ankylosing spondylitis
What you should share with your doctor
Those who are seeking diagnosis for joint pain or inflammation can help their health care providers by recording and sharing details about their symptoms.
It can be helpful to keep track of the following:
- When and how your symptoms first occurred
- If your pain gets better or worsens with exercise
- If different joints have been painful at different times
- If any treatments have relieved your pain
- If you’ve experience symptoms other than joint pain, such as eye problems, rashes, gastrointestinal problems, or fatigue
- If you have a family history of back pain and joint diseases
If your regular physician suspects you may have ankylosing spondylitis or another inflammatory condition, you may be referred to a rheumatologist, who specializes in diagnosis and treatment for these type of conditions.