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Tests and diagnosis
By Mayo Clinic staffDiagnosis of ankylosing spondylitis may be delayed if your symptoms are mild or if you mistakenly attribute some of your symptoms to more common back problems.
To determine the cause of your discomfort, your doctor will conduct a medical history and complete a physical examination. Then, your doctor may use the following diagnostic procedures:
- X-rays or other imaging. X-rays allow your doctor to check for changes in your joints and bones, though the characteristic effects of ankylosing spondylitis may not be evident early in the disease. Your doctor may also use other imaging tests, such as computerized tomography (CT) or magnetic resonance imaging (MRI) scans, to detect inflammation and other changes in your joints.
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Blood tests. Your doctor may check for indications of inflammation using one or more blood tests, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). In the ESR test, inflammation is signaled by elevation in the speed at which your red blood cells settle to the bottom of a tube of blood. The CRP test indicates inflammation by the presence of a protein that your liver produces as part of your immune system response to injury or infection.
Other tests used to diagnose ankylosing spondylitis include a complete blood count (CBC) to determine if you have anemia, a condition in which there aren't enough healthy red blood cells to carry adequate oxygen to your tissues. Anemia is a complication that can result from the chronic inflammation of ankylosing spondylitis. Finally, your doctor may check your blood for the HLA-B27 gene. The presence of this gene doesn't determine whether you have ankylosing spondylitis, but its absence makes it less likely.
- Yu DT, Patient information: Ankylosing spondylitis, http://www.uptodate.com/home/index.html. Accessed Nov. 10, 2008.
- Mercier LR, Ankylosing spondylitis. In: Ferri FF. Ferri's Clinical Advisor 2009. Philadelphia, Pa.: Mosby Elsevier; 2009. http://www.mdconsult.com/das/book/body/109354214-4/0/1701/48.html?printing=true. Accessed Nov. 5, 2008.
- Ankylosing spondylitis. Genetics Home Reference. http://ghr.nlm.nih.gov/condition=ankylosingspondylitis. Accessed Nov. 6, 2008.
- Taurog JD. The Spondyloarthritides: Anklyosing Spondylitis. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/content.aspx?aID=2862756&searchStr=ankylosing+spondylitis. Accessed Jan. 9, 2009.
- Song IH. Benefits and risks of ankylosing spondylitis treatment with nonsteroidal antiinflammatory drugs. Arthritis and Rheumatism. 2008;58(4):929-938.
- Yu DT. Treatment and prognosis of ankylosing spondylitis in adults. http://www.uptodate.com/home/index.html. Accessed Nov. 10, 2008.
