Magnetic resonance imaging (MRI) uses energy from a powerful magnet to produce signals that create a series of cross-sectional images. These images or “slices” are analyzed by a computer to produce an image of the joint. MRI can help diagnose ankylosing spondylitis in the early stages of the disease.
Diagnosis of Ankylosing Spondylitis
Musculoskeletal imaging, specifically MRI, plays an important role in early diagnosis and monitoring of ankylosing spondylitis.
More than 90% of people with ankylosing spondylitis have a particular genetic marker called HLA-B27, which can be found on their white blood cells. This marker does not appear to be the only cause, however, as 80% of people with this genetic marker never develop an inflammatory disease.
Chronic back pain and progressive spinal stiffness are the most common features of the disease.
There are no specific lab tests to identify ankylosing spondylitis. Certain blood tests can check for markers of inflammation, but many different health problems can cause inflammation. Blood can be tested for the HLA-B27 gene.
The hallmark feature of ankylosing spondylitis is the involvement of the sacroiliac (SI) joints during the progression of the disease. The SI joints are located at the base of the spine, where the spine joins the pelvis. More information on ankylosis and iritis can be found in the Complications section.
Ankylosing spondylitis (AS) is a type of arthritis. It causes pain and stiffness, mainly in your spine. But it can also cause eye inflammation called uveitis. Left untreated, uveitis can harm your vision and, in some cases, lead to blindness.
A diagnosis of AS can usually be confirmed if an X-ray shows sacroiliitis (inflammation of the sacroiliac joints) and you have at least one of the following: at least three months of lower back pain that gets better with exercise and doesn't improve with rest.
A rheumatologist is commonly the type of physician who will diagnose ankylosing spondylitis (AS), since they are doctors who are specially trained in diagnosing and treating disorders that affect the joints, muscles, tendons, ligaments, connective tissue, and bones.
U.S. FDA Approves Pfizer's XELJANZ® (tofacitinib) for the Treatment of Active Ankylosing Spondylitis.
If you're still looking for answers to your AS symptoms, your doctor may talk with you about the latest treatment for ankylosing spondylitis, Janus kinase (JAK) inhibitors. JAK inhibitors earned the Food and Drug Administration's green light for ankylosing spondylitis in 2021.
HLA-B27 and Ankylosing Spondylitis
One gene, HLA-B27, is strongly associated with a big family of rheumatic diseases called spondyloarthropathies. It includes: Axial spondyloarthritis.
Ankylosing spondylitis has no known specific cause, though genetic factors seem to be involved. In particular, people who have a gene called HLA-B27 are at a greatly increased risk of developing ankylosing spondylitis. However, only some people with the gene develop the condition.
Ankylosing spondylitis may affect more than the spine. The disease may inflame joints in the pelvis, shoulders, hips and knees, and between the spine and ribs.
What investigations should I arrange when ankylosing spondylitis is suspected? Spondyloarthritis cannot be reliably diagnosed or ruled out by a single test. Consider testing for erythrocyte sedimentation rate (ESR), and/or C-reactive protein (CRP).
Magnetic resonance imaging (MRI) and computed tomography (CT) scan are more sensitive than X-ray. If no changes to the sacroiliac joints show on the X-ray but your doctor still suspects AS, an MRI or CT scan may allow an earlier diagnosis. Ultrasound is being studied as a way to diagnose ankylosing spondylitis earlier.
At this time, no single test diagnoses ankylosing spondylitis. Your doctor may order a blood test to check for the HLA-B27 gene, which is present in most people with the disease. You may have the HLA-B27 gene and never develop ankylosing spondylitis, but it can give doctors more information when making a diagnosis.
What are the symptoms of an ankylosing spondylitis (AS) flare-up, and how can a person treat them? Symptoms of an AS flare-up can include fatigue, back stiffness, fever, depression, and joint pain. To treat an AS flare-up, a person can try medication, gentle exercise, and heat or cold therapy.
Ankylosing spondylitis is caused by Klebsiella.
If you have ankylosing spondylitis, you may have pain and stiffness at night, in the morning, or when you're not active. The pain may begin in the joints between your pelvis and spine and then move along your spine. Your pain may get better with movement or exercise.