Tests for ankylosing spondylitis

What physical tests are done exactly? Like does a doctor make you bend over and try to move around and if so can you give me details on the procedure and what the doctor checks for?

Here are two great websites for info on the spondyloarthropathies: (Ankylosing spondylitis being one of them)

Spondyloarthropathies: Using presentation to make the diagnosis

http://www.ccjm.org/PDFFILES/Brent304.pdf

Spondylitis Association of America; click on the "about Spondylitis" link at the upper left hand section.

http://www.spondylitis.org

Hope you find what you're looking for.

Jan

Thanks for the information, Jan. It helped a lot. I would like to know more about physicals and not blood and radiology tests.

hey Cyborg! did you get seen by the rheummy yet? how's it going?

elcamino,

From what I understand, the majority of people diagnosed with AS have negative results on the rheumatoid factor. Did you have a chance to read through those websites I posted above? Look in Key Points, third paragraph:

http://www.ccjm.org/PDFFILES/Brent304.pdf

It looks to me as if AS can occur in many of the same areas as RA, so a misdiagnosis could be possible, in my opinion. See the next site and click on the diagram. AS and the spondyloarthropathies usually affect the spine, but "other areas of the body can also be involved. Spondylitis does not follow the same course in everyone."  (I can't get the direct link to work, so click on "about Spondylitis", then "Complications of Spondylitis")

http://www.spondylitis.org/main.aspx

Also, that website, Spondylitis Association of America is a very comprehensive, EXCELLENT site. Many of the topics can be accessed without paying or becoming a member. http://www.spondylitis.org/main.aspx 

Their message board is also good:  http://bbs.spondylitis.org/cgi-bin/ultimatebb.cgi

Regarding Enbrel for Crohn's, I've only read one article on PubMed that showed Enbrel had some benefit for Crohn's patients.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=11569676&query_hl=1&itool=pubmed_DocSum

All other articles I've seen indicate that Enbrel works for the arthritis symptoms in Crohn's patients, but not the digestive symptoms:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=12480676&query_hl=1&itool=pubmed_DocSum

There's even one that suggests that Enbrel  "may have contributed to the development of clinically significant inflammatory bowel disease."

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=15801037&query_hl=1&itool=pubmed_docsum

Go figure!!

Oh, by the way, I had a remarkable response to my first Enbrel injection in December 2004. My previous rheumatologist, who first prescribed it, didn't believe me when I told him I noticed a difference within three days. After one month, my ESR had gone from 46 to 6. Our insurance plan was switched (not by choice!) in 2005, so I had to find all new docs - GI, rheumatologist, ophthamologist, GP, what a pain in the neck, literally!

My current GI suggested once that Enbrel may be benefitting my questionable IBD. My last ileo-colonoscopy in Nov' 05 showed no abnormalities macroscopically or microscopically. His other theory is that my so-called IBD could be the result of the nsaids I was using for my inflammatory arthritis at the time of my first bowel flare (diagnosed by my previous GI doc as moderate-severe UC in January 2003, even though the pathologist report suggested Crohns, due to granulomas, chronicity, and the patchy nature of inflammation.) The following study was submitted by my current GI doc, who believes the use of nsaids can cause damage to the small intestine and/or the colon.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=15017486&query_hl=46&itool=pubmed_docsum

In another post you mentioned a similar situation, so maybe your GI doc has been conversing with mine...!!

So I have no answers for any of this, only never-ending questions and continued searches for bits and pieces of the giant PUZZLE, as I continue to inject my treasured Enbrel and enjoy relatively good health.

Good luck to you, elcamino.

Jan

 

Current dx: seronegative rheumatoid arthritis first diagnosed in 1991,

                (or a spondyloarthropathy, tested HLA-B27 positive in 2004)

                recurrent iritis, one episode of papillitis, Raynaud's, 

                 questionable IBD (UC, Crohn's or none)

Current prescriptions: Enbrel

Past prescriptions: plaquenil, naproxen, relafen, piroxicam, vioxx, imuran, methotrexate, entocort, asacol, prednisone, flagyl

I have AS & RA. I'm B27 positive and seronegative for the RA factor. Bear in mind that RA typically affects joints on both side (both hands, both feet, etc) and quite frequently (not always) the peripheral joints. AS on the other hand, doesn't necessarily strike in 2's, doesn't always hit the peripheral joints and generally will hit the neck, spine (Cervical down to the Sacral), and feet. You can be B27 negative and have AS, you can be B27 positive and NOT have AS. Enbrel worked for me for a long time, but it does nothing for IBD's or Iritis. Since I have AS, RA & CD, I've been switched over to Remicade. A good percentage of people with AS will have IBS or IBD to go along with it.

The best way of diagnosis for AS truly is through some sort of Xray or scans. Blood tests do not always tell the real story. My sed rates and related tests are generally normal, even in the midst of my worst flares. Look at my xrays though and I'm a mess! Sacroilitis is the hallmark of AS and we women generally have SI involvement more frequently than men.

There are great references listed above, but I wanted to add my two cents as well. Hope you don't mind.

Recently I was diagnosied with AS . It took 15 years and many docters and a lot of pain . I am reluctant to try emberal . I was wondering if anyone has a suggestion.

Mike