How is ankylosing spondylitis diagnosed?
If symptoms are mild, diagnosis may take some time, because the doctor and patient may just think it is a common back problem.
However, the back pain features are distinctive in that they are worse in the morning and after periods of inactivity, and improve during the day or after 30 minutes of activity; pain is also worse during the second half of the night and may wake up the patient.
The doctor may order blood tests which may help rule out some other conditions or illnesses, while at the same time providing valuable data if AS is suspected. Blood tests may include:
If the doctor is a primary care physician (GP, general practitioner, family doctor), and ankylosing spondylitis is suspected, the patient will be referred to a specialist; a rheumatologist who will order further diagnostic tests.
The rheumatologist may order the following tests:
The doctor may be able to make a diagnosis after seeing the diagnostic test results. However, often AS takes a long time to develop; damage might not be detectable. Diagnosis of AS can sometimes take a very long time.
What is “probable ankylosing spondylitis”? – if the patient has sacroiliitis but none of the three features listed above, or has all of the three features but not sacroiliitis.
Advances in MRI techniques and technology are making it possible to diagnose AS earlier on during the disease’s development.
What are the treatment options for ankylosing spondylitis?
Ankylosing spondylitis is not irreversible, it cannot be cured. Treatment focuses on relieving the pain and stiffness that comes with the disease, preventing them from undermining the patient’s ability to go about daily life, and slowing down the development of the disease. Experts say treatment is most effective if it can start before irreversible damage to the joints has occurred.
Although AS is a long-term condition, patients with the right treatment can live relatively normal and independent lives.
Physical therapy for ankylosing spondylitis
Medication for ankylosing spondylitis
Painkillers, Tumour necrosis factor (TNF) blocker, Bisphosphonates, DMARDs (Disease-modifying anti-rheumatic drugs), Corticosteroids, Surgery
What are the possible complications with ankylosing spondylitis?
Ankylosing spondylitis affects everyone in different ways – no two people will follow a set course. If there are complications, which are much more likely if the disease is untreated, they may include:
- Uveitis (iritis)
- Compression fractures
- Cardiovascular disease
- Inflamed aorta
- Cauda equina syndrome