Spondyloarthritis / Spondylitis Forums - Spondylitis Association of America
Spondylitis Association of America Home Page Learn About Spondyloarthritis / Ankylosing Spondylitis About Us - Our Work More Ways To Connect With Others / Support Groups And More Become a Member of SAA We Are A Nonprofit - Donate Today Shop for Products
Topic Options
#278556 - 07/13/17 05:18 PM How sure is diagnosis?
Sitilydnops Offline
Registered Visitor

Registered: 07/13/17
Posts: 4
Hey guys,

32 Male here. Been dealing with the symptoms for a little under 20 years now.

Have not been diagnosed but in the process.

Question: How sure is diagnoses. That is, if I do the test, and I have Spondylitis, what is the likelihood that I will have a positive diagnosis? Is it 100%? Or is it a gray area like a lot of other things?

Top
#278557 - 07/13/17 05:37 PM Re: How sure is diagnosis? [Re: Sitilydnops]
drizzit Offline
Registered Visitor

Registered: 02/18/06
Posts: 1936
There is no one test for AS. Early on AS diagnosis is a gray area and that is why so many suffered for years until definite damage showed up and confirming a diagnosis.

You have to rely on the Rheumy so make sure you have one you trust and like.

Top
#278558 - 07/14/17 08:16 AM Re: How sure is diagnosis? [Re: Sitilydnops]
Winston Offline
Registered Visitor

Registered: 06/30/16
Posts: 188
Which test are you talking about? The HLA-B27 test is not diagnostic because the overwhelming majority of people with the gene will never develop disease and it's possible to have the disease without having the gene. The blood tests, ESR and CRP, can tell you whether you have systemic inflammation but don't tell you what's causing the inflammation. And up to 30% of people suffering from AS will never have an elevated ESR or CRP. Spinal damage characteristic of AS on xray is the closest thing we have to a diagnostic test. An MRI (with contrast) of the sacroiliac joints can help diagnose early AS before spinal damage is apparent on xray.

Top
#278562 - 07/15/17 02:53 AM Re: How sure is diagnosis? [Re: Winston]
Sitilydnops Offline
Registered Visitor

Registered: 07/13/17
Posts: 4
Originally Posted By: Winston
Which test are you talking about? The HLA-B27 test is not diagnostic because the overwhelming majority of people with the gene will never develop disease and it's possible to have the disease without having the gene. The blood tests, ESR and CRP, can tell you whether you have systemic inflammation but don't tell you what's causing the inflammation. And up to 30% of people suffering from AS will never have an elevated ESR or CRP. Spinal damage characteristic of AS on xray is the closest thing we have to a diagnostic test. An MRI (with contrast) of the sacroiliac joints can help diagnose early AS before spinal damage is apparent on xray.


Ultimately I'm getting an MRI of the sacroiliac joints. I've already got severe spinal damage in the lower back, and I've never had anything done to look at the upper.

My concern about the sacroiliac joint MRI is that I use to have EXTREME pelvic pain and complications. But through years of sleepless nights and experimentation, I have been able to eliminate most of that pain through yoga and stretching. This was no easy task. I ripped my knees hamstrings several times in the process. Literally reshaping my body.
The tree-branch snapping sounds don't occur anymore. And the nagy pain that didn't alow me to sleep is gone as well.

Of course, I still have some complications in the pelivc region but Its nothing like it use to be up until a year ago. What do you think, will the MRI still show results?

Top
#278564 - 07/15/17 09:35 AM Re: How sure is diagnosis? [Re: Sitilydnops]
Winston Offline
Registered Visitor

Registered: 06/30/16
Posts: 188
An MRI will tend to show active inflammation in bones and soft tissues. Xray actually shows the abnormal bone growth characteristic of AS, e.g., syndesmophytes, better than MRI. So, if you haven't had one, I would ask for an xray of the SI joints and lumbar spine in addition to the MRI.

Also, a rheumatologist can diagnose AS without radiographic evidence. It's harder to convince insurance companies to pay for biologics without that evidence, but not impossible.

Top
#278566 - 07/15/17 03:44 PM Re: How sure is diagnosis? [Re: Winston]
Sitilydnops Offline
Registered Visitor

Registered: 07/13/17
Posts: 4
Originally Posted By: Winston
An MRI will tend to show active inflammation in bones and soft tissues. Xray actually shows the abnormal bone growth characteristic of AS, e.g., syndesmophytes, better than MRI. So, if you haven't had one, I would ask for an xray of the SI joints and lumbar spine in addition to the MRI.

Also, a rheumatologist can diagnose AS without radiographic evidence. It's harder to convince insurance companies to pay for biologics without that evidence, but not impossible.


Thanks for the info! I'm actually getting both the MRI and the Xray.

I had two hip surgeries due to extra bone growth and I know I have unilateral transverse sacralisation from an MRI I had years ago.

Top
#278580 - 07/16/17 02:56 PM Re: How sure is diagnosis? [Re: Sitilydnops]
SAMum Offline
Registered Visitor

Registered: 06/08/14
Posts: 64
I think it is still true that the first step is an Xray using the Ferguson view. Xrays are cheap and if that shows damage, you are done. If it doesn't, the doctor will then order an MRI with STIR imagery to check for inflammation of the sacroiliac joints.

Top
#278582 - 07/16/17 04:31 PM Re: How sure is diagnosis? [Re: SAMum]
Sitilydnops Offline
Registered Visitor

Registered: 07/13/17
Posts: 4
Originally Posted By: SAMum
I think it is still true that the first step is an Xray using the Ferguson view. Xrays are cheap and if that shows damage, you are done. If it doesn't, the doctor will then order an MRI with STIR imagery to check for inflammation of the sacroiliac joints.


Right, thats the plan. Getting the Xray sometime this week.

Top


Moderator:  ElinAslanyan