How is Ankylosing Spondylitis diagnosed?

See how Ankylosing Spondylitis is diagnosed. Which specialists are essential to meet, what tests are needed and other useful information for the diagnosis of Ankylosing Spondylitis


How is Ankylosing Spondylitis Diagnosed?


Ankylosing Spondylitis (AS) is a chronic inflammatory disease that primarily affects the spine, causing pain, stiffness, and eventually leading to fusion of the vertebrae. Early diagnosis and treatment are crucial to managing the symptoms and preventing long-term complications. Diagnosing AS involves a combination of medical history, physical examination, imaging tests, and laboratory tests.



Medical History


The first step in diagnosing AS is a detailed medical history. The doctor will ask about your symptoms, their duration, and any family history of AS or other autoimmune diseases. It is important to provide accurate information about your symptoms, including the location and intensity of pain, morning stiffness, and any other associated symptoms.



Physical Examination


During the physical examination, the doctor will assess your range of motion, flexibility, and any signs of inflammation. They may check for tenderness and swelling in the joints, especially in the spine and sacroiliac joints. The doctor may also evaluate your posture and look for any signs of spinal deformity or limited mobility.



Imaging Tests


Imaging tests play a crucial role in diagnosing AS. The most commonly used imaging techniques include:




  • X-rays: X-rays can reveal changes in the spine and sacroiliac joints, such as fusion, erosion, and new bone formation. However, these changes may take time to develop, so early-stage AS may not be visible on X-rays.

  • Magnetic Resonance Imaging (MRI): MRI uses powerful magnets and radio waves to create detailed images of the spine and other affected areas. It can detect inflammation and early structural damage even before it appears on X-rays, making it a valuable tool for early diagnosis.

  • Computed Tomography (CT) Scan: CT scans provide detailed cross-sectional images of the spine and can help identify bony changes, especially in the later stages of AS.



Laboratory Tests


Laboratory tests are not definitive for diagnosing AS, but they can help support the diagnosis and rule out other conditions. The most commonly ordered tests include:




  • Blood Tests: Blood tests can measure certain markers of inflammation, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Elevated levels of these markers may indicate ongoing inflammation in the body.

  • Genetic Testing: A specific genetic marker called HLA-B27 is present in the majority of individuals with AS. However, having HLA-B27 does not necessarily mean you have AS, as it can also be found in other conditions.



Consultation with a Rheumatologist


AS is a complex condition that requires specialized knowledge for accurate diagnosis and management. If your primary care physician suspects AS based on your medical history, physical examination, and initial tests, they may refer you to a rheumatologist. Rheumatologists are doctors who specialize in diagnosing and treating autoimmune and inflammatory diseases, including AS. They will further evaluate your symptoms, review the test results, and make a definitive diagnosis.



Monitoring and Follow-up


Once diagnosed with AS, regular monitoring and follow-up with a rheumatologist are essential. AS is a chronic condition that requires ongoing management to control symptoms, prevent complications, and maintain a good quality of life. Your rheumatologist will develop a personalized treatment plan based on the severity of your symptoms, disease progression, and your overall health.



In conclusion, diagnosing Ankylosing Spondylitis involves a comprehensive approach that includes medical history, physical examination, imaging tests, and laboratory tests. Early diagnosis is crucial for timely intervention and effective management of the disease. If you suspect you may have AS, it is important to consult with a healthcare professional for a proper evaluation and diagnosis.


by Diseasemaps

For me it took 2 years of changes. Changing my meds, changing my diet, even buying a new bed. Then the x-rays and MRIs plus a blood test to see if I was HBL-27 positive.

3/4/17 by Denise 450

Majority of people is still diagnosed too late, when the disease has already progressed, but pay attention if you have the following symptoms. And insist of getting an MRI done if nothing is shown on the X ray. Symptoms Early signs and symptoms of ankylosing spondylitis might include pain and stiffness in your lower back and hips, especially in the morning and after periods of inactivity. Neck pain and fatigue also are common. Over time, symptoms might worsen, improve or stop at irregular intervals. The areas most commonly affected are: The joint between the base of your spine and your pelvis (sacroiliac) The vertebrae in your lower back The places where your tendons and ligaments attach to bones (entheses), mainly in your spine, but sometimes along the back of your heel The cartilage between your breastbone and ribs Your hip and shoulder joints When to see a doctor Seek medical attention if you have low back or buttock pain that came on slowly, is worse in the morning or awakens you from your sleep in the second half of the night — particularly if this pain improves with exercise and worsens with rest. See an eye specialist (ophthalmologist) immediately if you develop a painful red eye, severe light sensitivity or blurred vision. A rheumatologist is commonly the type of physician who will diagnose ankylosing spondylitis (AS), since they are doctors who are specially trained in diagnosing and treating disorders that affect the joints, muscles, tendons, ligaments, connective tissue, and bones.

3/4/17 by kat1 1050

To obtain a diagnosis of AS it is usually done by a Rheumatologist but other doctors could catch if they are familiar with autoimmune disorders. Bloodwork is typically done and there is a gene marker HLA-B27 that is significant for AS and usually hereditary. Just because you have the gene does not mean you have the active disease and you can also have it and not have the market. The Dr also does a physical exam and ask about symptoms and what you have and how long you have been dealing with them. They do Cray usually in the beginning as well especially if SI joints and hands looking for any fusion or damage that may/may not be showing yet. For treatment a Rheumatologist is usually who treats although you still follow with your pcp and sometimes pain management as well and if you have any other areas of concern you would follow that speciality Dr as well.

3/5/17 by Heather 1120

MRI of spine and SI joints. Most diagnosed hla-b27 positive.

5/17/17 by Shannon 1050

Typically patients see a rheumatologist for a reviewof their health history, family history, symptoms, and often imaging such as xrays and blood work to look for genetic markers and inflammation markers. The information helps the specialist evaluate your specific situation.

5/17/17 by Keli 1050

Blood test and symptoms

5/18/17 by Karlie 1150

Blood test X-ray specialists

5/18/17 by kelly cannell 500

It is a combination of factors. Testing positive for the gene HLA-B27 can be a good indicator. Symptoms and evidence of damage seen on either X-rays or an MRI

5/19/17 by Kylie Frost 2120

For me it is kind of a catch all diagnosis as I was damaged by Flouroquinelones (Cipro and Levaquin) so there is no real classification for us.

5/19/17 by Tamra 1750

X-RAY or MRI. Blood tests I'm not sold on.

7/24/17 by 1000

Blood tests, x-rays, MRIs and CT scans

8/31/17 by BigStu111 12832

Having symptoms of low back and join pains, a positive reading of the HLA-B27 Gene though negative B27 readings can be confirmed with certain x-rays and targeted Cat Scans to inflammation of vertebra.

9/6/17 by Daniel Wilson 2010

By MRI and x-ray is how it was diagnosed for me. Rheumatologist and a Pain Doctor is essential for us diagnosed. It depends on what the doctor finds needed as AS is not the same for everyone.

9/7/17 by Luciano Scariano 2600

Blood tests MRI X-rays Medical check Medical performance tests

9/7/17 by Carol 600

I underwent a myriad of blood work, MRIs and X-rays.

9/10/17 by Sal 4050

Back Pain,Leg Pain,HLB-27,X-rays

9/21/17 by Rana Navid Anwaar Khan 3945

Diagnosi con HLA RISONANAZA magnetica Raggi x Ves Pcr Protidogramma

10/1/17 by Silvia 2500

Nowadays when looking at the classification criteria for Ankylosing Spondylitis following the Assessement of Spondyloarthritis International Society, it almost look that it could be simple and quick. Unfortunately, depending on so many factors as the health system of the country, doctors, patients, access to investigation and many other reason can lead to years of misdiagnose. Doctors working with specialists as Rhumatologist are necessary. Usually an X-Ray will be needed, but sadly only once the damaged are irreversible this way could help for diagnose, this is why in nowadays MRI are much more efficient to help early diagnose as they can help see inflammation at an early stage before bone ossification. Also one of the criteria that can help is the test of the gene HLA-B27. If positive that can reinforce the supposition of the illness but it should by no means exclude the illness! As it is known by now that more than 100 genes can be related to AS and that many patients who have AS don't have HLA-B27. But a few questions like: did the pain last more than 3 months? did it started before 45 years old? did the pain get better or worse with exercice? did the pain wakes up during the night? did the pain came gradually over time? Can already help to understand if the patient might be suffering from an inflammatory condition and help to actually take the right step towards the right direction for a diagnose.

2/16/18 by Laeti 3570

A combination of signs, visualized by the health care provider, symptoms you report, as well as radiographs and a blood test called hla b27

5/31/18 by Colleen 2550
Translated from portuguese Improve translation

It is diagnosed after several tests, such as HLA-B27, blood tests, magnetic resonance imaging, and after these examinations, consultation with a rheumatologist.

8/10/17 by Andressa. Translated
Translated from portuguese Improve translation

Diagnosis physical, rsonancia and analyze genetic

8/14/17 by Luz. Translated
Translated from portuguese Improve translation

Examinations through x-ray, magnetic resonance imaging, marker hla-b27, physical examination.

8/15/17 by Adriana. Translated

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