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What is ankylosing spondylitis?

View profile for Judith Thomas-Whittingham
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Is cauda equina syndrome a permanent disability?

Ankylosing spondylitis (AS) is a painful form of inflammatory arthritis. It includes non-radiographic AS which is where X-ray changes are not present but inflammation is visible on an MRI in the sacroiliac joints or spine. Radiographic AS is where changes to the sacroiliac joints or spine can be seen on X-ray.

Spondyloarthritis is often missed in non-specialist settings, leading to substantial delays in diagnosis and treatment. This is in part due to the prevalence of lower back pain. Doctors and other medical professionals may in some instances refer for physiotherapy and do not ask for diagnostic tests to be done. If some of these symptoms are present tests should be carried out:

  • Slow or gradual onset of back pain and stiffness over weeks and months as opposed to days
  • Early morning stiffness that wears off over the course of the day
  • Persistent lasting longer than 3 months
  • Feeling better after exercise and worse after rest
  • Weight loss
  • Fatigue and tiredness
  • Feeling feverish
  • Psoriasis

About a quarter of people with the condition will have an attack of acute anterior uveitis which is inflammation in the front part of their eyes, and some will develop inflammatory bowel disease.

What tests should be carried out?

  • A flexibility test to test joint tenderness and flexibility
  • Blood tests to look for inflammatory markers
  • A blood test to see if a person carried the HLA-B27 gene. However, carrying the gene does not mean a person has AS or will develop it but it is an indicator towards spondylitis
  • X -rays to look at changes in the bones of bone growth
  • MRI scan. With the MRI scan the whole spin and pelvis should be scanned and a specific STIR sequence used to diagnose the condition. It is important that this specific sequence is carried out in MRI scanning

Because the condition is less well known it maybe missed or assumed to be caused by something else.

What happens if it is missed?

If untreated, after a prolonged period it may lead to complications such as:

  • Blurred vision
  • Joint damage
  • Reduce flexibility
  • Cardiovascular disease
  • Amyloidosis

If you have had a delay in diagnosis for the condition and think you may have complications as a result call our spinal and medical negligence experts today on 0161 696 6165 or complete our online enquiry form and we will contact you directly.