What to check for ankylosing spondylitis?

Written by Yang Ya Meng

Rheumatology

Updated on October 22, 2024

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The examination for ankylosing spondylitis mainly includes blood tests. The main components of the blood tests are erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), ANA along with CCP antibodies, and AKA antibodies, and of course, the most crucial test related to the gene - HLA-B27. Imaging exams can include the following: First, an X-ray of the pelvis, or an MRI of the sacroiliac joints. If the disease has been present for a longer time, a CT of the sacroiliac joints can be chosen. If the patient has elevated ESR and CRP, a positive B27, and lesions in the sacroiliac joints, then the diagnosis of ankylosing spondylitis can be confirmed.

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Written by Yang Ya Meng

Rheumatology

1min 2sec

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What tests are done for ankylosing spondylitis?

The main laboratory indicators for ankylosing spondylitis include the following: Testing for the B27 gene, formally known as HLA-B27 gene, which is hereditary and commonly found in male patients. Second, to determine if ankylosing spondylitis is in an active phase, inflammatory markers such as erythrocyte sedimentation rate and C-reactive protein can be checked. Moreover, the diagnosis of ankylosing spondylitis must involve the sacroiliac joints being affected. Therefore, a CT scan and MRI of the sacroiliac joints can be conducted to determine if there are issues with the sacroiliac joints. If the patient shows symptoms of inflammatory lower back pain, has affected sacroiliac joints, tests positive for the B27 gene, and shows elevated inflammatory markers, then a diagnosis of ankylosing spondylitis can generally be confirmed.

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Written by Na Hong Wei

Orthopedics

1min 4sec

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Symptoms of ankylosing spondylitis

The main symptom of ankylosing spondylitis is pain, characterized by pain in the lower back and lumbar region. The pain occurs during rest and diminishes with activity; it is especially severe at night, often waking the sufferer, who then finds mild activity alleviates the pain enough to return to sleep. As the disease progresses, chest pain and restricted rib cage movement begin, due to the disease spreading to the thoracic vertebrae and eventually reaching the cervical vertebrae in later stages, resulting in difficulty moving the neck. Early physical signs include tenderness in the sacroiliac joints and paraspinal muscles. X-rays can reveal that the sacroiliac joints are often the first to be affected, usually showing sacroiliitis. Additionally, there is a particularly high positivity rate for HLA-B27, the human leukocyte antigen B27, which can reach up to 90%, whereas it is typically around 4%-9% in the general population.

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Written by Yang Ya Meng

Rheumatology

1min 1sec

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How is ankylosing spondylitis treated?

The treatment of ankylosing spondylitis mainly consists of three types: The first is anti-inflammatory pain relief, primarily using non-steroidal pain relief medications, such as sustained-release diclofenac sodium tablets. The second is the selection of disease control medications, mainly involving drugs like sulfasalazine tablets. For ankylosing spondylitis, the most effective and economically expensive treatment is biological agents therapy. We commonly use drugs such as tumor necrosis factor antagonists. Patients with ankylosing spondylitis during acute pain periods are advised not to engage in intense exercise. However, during remission periods, appropriate functional exercises are recommended to prevent the adhesion and stiffness of spinal joints.

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Written by Yang Ya Meng

Rheumatology

49sec

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How to control ankylosing spondylitis

The treatment of ankylosing spondylitis mainly consists of three parts: The first part is the use of non-steroidal anti-inflammatory drugs, such as sustained-release diclofenac sodium tablets; the second is the choice of disease control medications, which may include sulfasalazine or methotrexate tablets, especially for patients with peripheral joint pain, immunosuppressive drugs can be chosen. The most effective for ankylosing spondylitis are biologics, but before using biologics, it is necessary to exclude hepatitis, tuberculosis, and cancerous diseases, and the cost of biologics is relatively high. (Please use medications under the guidance of a professional physician and do not self-medicate.)

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Written by Li Jing

Rheumatology

1min

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Is ankylosing spondylitis hereditary?

Ankylosing spondylitis is a systemic autoimmune disease of unclear etiology characterized by chronic inflammation primarily affecting the axial joints, mainly involving the sacroiliac joint. The cause is unclear, and research by experts has shown that the disease tends to run in families, indicating familial clustering. It is not classified as a genetic disease, but there is both familial clustering and a genetic predisposition, meaning that if parents have the disease, their children are much more likely to develop it compared to others. Therefore, if symptoms such as lower back pain or neck stiffness occur, it is advisable to undergo thorough examinations and seek early diagnosis and treatment to delay joint deformity and control the progression of the disease.