Ankylosing spondylitis is a type of chronic inflammatory arthritis that primarily affects the spine and pelvis. It is a form of axial spondyloarthritis, which is a type of arthritis that affects the axial skeleton, which includes the spine, sacroiliac joints, and hip joints. In order to rule out ankylosing spondylitis, a physician will usually begin with a thorough physical exam and review of the patient’s medical history. They may then order imaging scans such as X-rays or MRIs to look for signs of spinal fusion or deformity. Blood tests may also be ordered to look for biomarkers associated with ankylosing spondylitis, such as the HLA-B27 gene.
The physician may also ask the patient questions about their symptoms and family history. This includes questions about any back pain, stiffness, and fatigue they may be experiencing, as well as any family history of ankylosing spondylitis. The patient may also be asked about their lifestyle, including any physical activities they may be engaged in.
If it is suspected that the patient may have ankylosing spondylitis, a referral to a rheumatologist may be made for a more detailed evaluation. The rheumatologist may perform a detailed physical exam and ask more questions about the patient’s symptoms and medical history. They may also order additional imaging scans and blood tests to confirm the diagnosis.
In some cases, a diagnosis of ankylosing spondylitis can be made based on the patient’s symptoms and family history without the need for any additional testing. However, the diagnosis should always be confirmed with additional testing before any treatment is started.