Our expert says:
A rheumatologist is commonly the type of physician that will diagnose ankylosing spondylitis. A thorough physical exam including x-rays, individual medical history, and a family history of AS, as well as blood work including a test for HLA-B27 are factors in making a diagnosis.
The overall points taken into account when making an AS diagnosis are:
Onset is usually under 35 years of age.
Pain persists for more than 3 months (i.e. it is chronic).
The back pain and stiffness worsen with immobility, especially at night and early morning.
The back pain and stiffness tend to ease with physical activity and exercise.
Positive response to NSAIDs (nonsteroidal anti-inflammatory drugs).
A physical examine will entail looking for sites of inflammation. Thus, your doctor will likely check for pain and tenderness along the back, pelvic bones, sacroiliac joints, chest and heels. During the exam, you doctor may also check for the limitation of spinal mobility in all directions and for any restriction of chest expansion.
Other symptoms and indicators are also taken into account including a history of iritis or uveitis (inflammation of the eye), a history of gastrointestinal infections (for example, the presence of Crohn's Disease or ulcerative colitis), a family history of AS, as well as fatigue due to the presence of inflammation.
The hallmark of AS is involvement of the sacroiliac (SI) joint ). The x-rays are supposed to show erosion typical of sacroiliitis. Sacroiliitis is the inflammation of the sacroiliac joints. Using conventional x-rays to detect this involvement can be problematic because it can take 7 to 10 years of disease progression for the changes in the SI joints to be serious enough to show up in conventional x-rays.
If you are looking for a more natural route to manage your back please consult your nearest osteopath. For more information on osteopathy visit www.osteogoodhealth.com
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