Spondylitis – The Path to Diagnosis

Posted on August 16, 2018

Article written by
Kelly Crumrin

Spondylitis is typically diagnosed and treated by a rheumatologist – a specialist in autoimmune and musculoskeletal diseases. However, most people with chronic (lasting for at least three months) low back pain go first to their primary care physician for help. Spondylitis is often misdiagnosed, or diagnosis is delayed – especially when spondylitis symptoms are mild. Many primary care doctors lack awareness or understanding of spondylitis and may miss the signs. In one study, it took an average of 307 days between the general physician diagnosing back pain and referral to a rheumatologist. Misdiagnosis and delayed diagnosis can delay treatment and allow spondylitis to progress, causing damage to joints.

How is spondylitis diagnosed?

There is no one test that is conclusive for a diagnosis of spondylitis. Spondylitis is generally diagnosed through a combination of a physical examination, family history, blood tests, and imaging scans. The rheumatologist carefully considers many different test results before concluding that spondylitis is the correct diagnosis or ruling it out.

Different types of spondylitis are diagnosed in slightly different ways. Some types, such as psoriatic arthritis and enteropathic arthritis, may develop in people with established diagnoses of, respectively, psoriasis and inflammatory bowel disease.

Physical exam and family history

Typically, the rheumatologist will start by examining your joints to check for tenderness, swelling, redness, warmth, and symmetry – whether symptoms appear on the same joints on both sides of the body. Range of motion, mobility limitations, and associated pain will also be assessed. You may also be asked about the history of your symptoms as well as family medical history with spondylitis or other autoimmune diseases such as multiple sclerosis, rheumatoid arthritis, and lupus.

Imaging

Diagnosis may also involve blood tests or imaging procedures such as X-rays, computed tomography (CT), or magnetic resonance imaging (MRI) scans. Scans allow the doctor to check for joint damage during diagnosis, and later measure how the disease progresses over time.

Lab tests

Although no lab test is conclusive for spondylitis, blood test results provide important clues that make a spondylitis diagnosis seem more likely or help rule it out.

Blood tests can check overall levels of inflammation by examining erythrocyte sedimentation rate (ESR, or sed rate) and C-reactive protein (CRP). At elevated levels, both ESR and CRP are considered signs of inflammation and can indicate whether spondylitis or another inflammatory condition is likely.

Blood can be tested for the presence of a specific gene, HLA-B27, which is present in many people with spondylitis. The presence of HLA-B27 increases the likelihood of spondylitis, especially in people of European descent.

At what age does spondylitis start to develop?

Spondylitis most commonly develops before age 45, with most people experiencing their earliest symptoms in their 20s or 30s.

Resources

External resources

Internal resources

FAQ

What other conditions can resemble spondylitis?

Spondylitis is frequently mistaken for other chronic health conditions including osteoarthritis, rheumatoid arthritis, and fibromyalgia. Spondylosis not only shares some symptoms with spondylitis, but also has a similar name. Read about the differences between spondylitis and spondylosis.

Kelly leads the creation of content that educates and empowers people with chronic illnesses. Learn more about her here.

A MySpondylitisTeam Member said:

Thanks for the hugs.

posted 9 months ago

hug (11)

Recent articles

Coronavirus
Article written by Kelly Crumrin Those of us living with pre-existing, chronic conditions such as...

Canceling Is Kindness: Keeping Safe From COVID-19 With Spondylitis

Article written by Kelly Crumrin Those of us living with pre-existing, chronic conditions such as...
Setting intentions for 2020 with spondylitis
Eat healthier. Exercise more. Learn a new skill. Pay off a credit card. Many of us have made...

Setting Intentions for 2020 With Spondylitis

Eat healthier. Exercise more. Learn a new skill. Pay off a credit card. Many of us have made...
Practicing gratitude with spondylitis
This time of the year can be overwhelming with expectations around the holidays, and living with...

Practicing Gratitude With Spondylitis

This time of the year can be overwhelming with expectations around the holidays, and living with...
Chest pain and spondylitis
Do you frequently experience chest pain with spondylitis? You’re not alone. Chest pain is a...

Chest Pain and Spondylitis

Do you frequently experience chest pain with spondylitis? You’re not alone. Chest pain is a...
Spondylitis and brain fog
Forgetting names. Losing words. Trouble concentrating. “Brain fog” is a common - and disturbing -...

Spondylitis and Brain Fog

Forgetting names. Losing words. Trouble concentrating. “Brain fog” is a common - and disturbing -...
How to enjoy the holidays despite spondylitis
Living with spondylitis may change your holidays, but you can still have enjoyable and meaningful...

How to Enjoy the Holidays Despite Spondylitis

Living with spondylitis may change your holidays, but you can still have enjoyable and meaningful...
Eye inflammation with spondylitis
Do you live with spondylitis and have recurring problems with your eyes? You’re not alone. Many...

Eye Inflammation With Spondylitis

Do you live with spondylitis and have recurring problems with your eyes? You’re not alone. Many...
Mht af justdiagnosed male
We all respond differently to information about our health. After learning you have spondylitis...

You’ve Just Been Diagnosed With Spondylitis. Now What?

We all respond differently to information about our health. After learning you have spondylitis...
How good boundaries make life with spondylitis easier
There is an old saying: “Good fences make good neighbors.” Having healthy boundaries in...

How Good Boundaries Make Life With Spondylitis Easier

There is an old saying: “Good fences make good neighbors.” Having healthy boundaries in...
Mht af saying thinking 1
Living with spondylitis can mean having limited energy, time, and bandwidth. You may find...

Tap Into the Power of Directness: Use "I"

Living with spondylitis can mean having limited energy, time, and bandwidth. You may find...
MySpondylitisTeam My spondylitis Team

Get the latest articles about spondylitis sent to your inbox.

Not now, thanks

Privacy policy
MySpondylitisTeam My spondylitis Team

Thank you for signing up.

close