Ankylosing Spondylitis Research

Diagnosis
Normally you would see a rheumatologist to diagnose AS. A rheumatologist is a doctor specially trained in disorders that affect the joints, muscles, tendons, ligaments and bones of the human body. Since AS is an arthritic condition and requires frequent medical visits, it’s important to find a doctor you are comfortable with. Think of it as choosing a car. You don’t want a vehicle that may fail you. At the same time you don’t expect the car to run without maintenance. A good doctor-patient relationship is built on mutual understanding, commitment and team effort – especially when fighting AS.

During the physical exam, your rheumatologist will ask about your medical history, family history, perform x-rays and test for the gene HLA-B27. He or she will also search for sensitive areas – called “hot spots” – along your body for pain and tenderness, and look for any decreased range of motion in the joints.

Be prepared with your family’s medical history and any occurrences of iritis (inflammation of the eye), gastrointestinal infections and fatigue in your past. Also don’t expect the x-ray to detect any inflammation in the sacroiliac joints as it can take up to 10 years for changes in the SI joints to show up (SAA).

Chronic inflammatory back pain and stiffness is usually the first symptom of AS, though it is not enough to make a diagnosis. There is no specific diagnostic laboratory test or blood test for AS and misdiagnosis can occur during the early stages of disease progression (Khan). That’s why it’s important to get a regular physical exam at least once a year.

A positive result for HLA-B27 does not imply the diagnosis of AS. According to the SAA, about eight percent of the Caucasian population has the HLA-B27 gene, but only about two percent will eventually get AS. The connection between AS and HLA-B27 varies among ethnic groups: Seven percent of Northern Scandinavians with AS test positive for HLA-B27, 50 percent of African Americans living with AS have the HLA-B27 gene and 80 percent of AS patients from Mediterranean countries are positive for HLA-B27.

Some of the things your rheumatologist will look for (SAA):

• If you are the age of onset (15-35)
• If you have any tender or inflamed spots
• If the pain is chronic
• If the pain or stiffness came on gradually
• If back pain and stiffness worsens when immobile
• If back pain and stiffness eases during physical activity

Background

Causes