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Ankylosing spondylitis Diagnosis

Tests may include:

  • HLA-B27 antigen test is positive.
  • A spine X-ray or pelvis X-ray shows characteristic findings.
  • C-reactive protein and erythrocyte sedimentation rate may be elevated
  • Complete Blood Count may show mild anemia.

X-rays or Ct scan or MRI will show characteristic changes to the lower spine and where it connects to the pelvis.

More detailed explanation of Ankylosing spondylitis Diagnosis

Doctors usually diagnose the disease simply by the patient's report of pain and stiffness. Doctors also review spinal and pelvic x rays since involvement of the hip and pelvic joints is common and may be the first abnormality seen on the x ray. The doctor may also order a blood test to determine the presence of HLA-B27 antigen. When a diagnosis is made, patients may be referred to a rheumatologist, a doctor who specializes in treating arthritis. Patients may also be referred to an orthopedic surgeon, a doctor who can surgically correct joint or bone disorders.



The first step in the diagnosis of ankylosing spondylitis is to take a thorough history of symptoms and make a physical examination. The doctor may check for tenderness over the sacroiliac joint. The doctor may check range of motion in the lower back and in the entire spine, and may also measure the ability to expand the chest.

An x-ray of the pelvis can show inflammation or fusion of the sacroiliac joint and bony overgrowth or fusion of the spine.

Magnetic resonance imaging (MRI) or computed tomography (CT) scan of the back may show early effects of the disease on the sacroiliac joint and vertebrae.

Blood tests may be done to look for evidence of inflammation. Low-grade anemia (a lack of enough red blood cells or hemoglobin, which is the protein that carries oxygen in the blood) is also an indicator of chronic disease.

Tests are sometimes done to check for HLA-B27 when the diagnosis is in doubt. Generally, however, presence of HLA-B27 is useless as a diagnostic indicator, as many people with back pain of other causes may also have this gene.

Modified 6-10-2013    Information compiled from the National Institutes of Health

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