Yes, it is possible to be HLA B27 negative and still have spondylitis. 85% of people with axial spondylitis are HLA B27 positive, but that still leaves 15% of people who aren't.

I am negative also. After being told I had fibromyalgia for years, even when my ANA was 100, my pain management sent me to the professor over rheumatology at USF. He right away diagnosed me with AS. He put me on prednisone for a month with methotrexate, plaquinol , and asacol. I had almost immediate relieve from the prednisone. He never bothered testing for HLA B27.
When I looked into another Rheumatolgist she first test me for it and because it was negative she said I had fibromyalgia and not AS.
I read somewhere that a researcher has found other genetic markers than HLA B27 but I haven’t seen or heard they test for any others.

I am negative also. My doc said it doesn’t matter that much. I have AS in my neck and si joints/ lower back. All my blood work was also normal. I was misdiagnosed with fibromyalgia and now I was diagnosed “officially” last month. Trust yourself and be your own advocate. From so many years being undiagnosed I now live in pain 24/7. Don’t let that happen to you and don’t let them brush you off.

Being diagnosed negative HLA-B27 delayed proper diagnosis for me.

Doctors were not well informed about this "rare" disease, even though 1 in 300 (more or less) have it. Many radiologists need updating too. MRI without dye will likely not see AS, and the dye has become scarce and reserved for life-threatening conditions.

In my case, a lateral x-ray would have worked to recognize the traditional calcification connecting cervical joints and an SI joint (pelvis) x-ray with dye 10-20 years earlier.

Hope you have a good new year.

That’s true