Yes, it is possible to have ankylosing spondylitis with a normal ESR. Ankylosing spondylitis (AS) is an inflammatory arthritis of the spine and other body joints, and is often associated with elevated erythrocyte sedimentation rate (ESR). However, it is possible to have AS with normal ESR levels.
In general, a normal ESR level is defined as less than 20 mm/hr in women and less than 15 mm/hr in men. Elevated ESR levels are often seen in inflammatory and infectious diseases, and may be used as a marker for diagnosing AS. However, some individuals with AS may have normal ESR levels, which can make it difficult to diagnose the condition.
There are several reasons why an individual with AS may have a normal ESR. It is possible for an individual to have AS without any inflammation, which would result in normal ESR levels. Additionally, individuals with AS may have low levels of inflammation, which would not result in an elevated ESR. It is also possible for individuals to have AS with other conditions that have an elevated ESR, such as rheumatoid arthritis or systemic lupus erythematosus, which can mask the underlying AS.
In order to diagnose AS in individuals with normal ESR levels, other tests may be used to detect inflammation, such as C-reactive protein, rheumatoid factor, and x-ray imaging. Additionally, a physical examination and case history can be used to identify signs and symptoms of AS.
In conclusion, it is possible to have ankylosing spondylitis with normal ESR levels, and additional tests may be used to diagnose the condition in this situation.