How Is Ankylosing Spondylitis Assessed?
Diagnosing ankylosing spondylitis can be challenging because its symptoms are varied and often
overlap with other conditions, such as mechanical back pain. As a result, it may take several
years before a clear diagnosis is reached, sometimes up to eight to 14 years. In many cases, the
condition is only identified when more advanced changes such as spinal fusion have already
developed.
Medical History and Physical Examination
The process usually begins with a detailed review of symptoms, including how long the pain
has been present, what makes it better or worse and whether there is any family history of
similar conditions. During the examination, the doctor may assess spinal flexibility, chest
expansion and areas of joint tenderness.
Imaging Studies
Imaging plays an important role in identifying changes in the spine and sacroiliac joints.
X-rays are often used to look for structural changes or inflammation in these joints, though
early disease may not always be visible. MRI scans are more sensitive and can detect
inflammation at an earlier stage, before lasting damage develops.
Laboratory Tests
There is no single blood test that confirms ankylosing spondylitis. However, tests may be
carried out to check for markers of inflammation such as C-reactive protein and erythrocyte
sedimentation rate. The HLA-B27 gene may also be tested, although its presence alone is not
enough to establish a diagnosis.
Specialist Evaluation
Because of the complexity of the condition, assessment by a rheumatologist is often needed.
A specialist can interpret symptoms, imaging and test results together to confirm the
diagnosis and guide appropriate ankylosing spondylitis treatment.
