12. X-rays aren’t the only thing doctors use to help diagnose AS
While X-ray changes are what set apart nr-axSpA from AS, they aren’t the only thing to clinch a diagnosis. A rheumatologist will likely order blood tests to look for inflammatory markers and potentially the HLA-B27 gene, as well as review the patient’s history and symptoms and conduct a thorough physical exam. “It’s really more of an art than a science at this point,” says Dr. Kumar.
13. It can take a long time to get diagnosed with AS
Study findings vary, but patients who are ultimately diagnosed with AS usually experience a significant delay between when they first experience symptoms and when they learn they have AS. One 2016 study in the journal Archives of Rheumatology found that the average delay was eight years. Women tend to take longer to be diagnosed with AS than men. Being negative for the HLA-B27 genetic marker and having enthesitis, or inflammation where tendons and ligaments connect to bone, such as at heel or bottom of the foot, was also associated with longer diagnostic delays.
14. Misdiagnoses of other conditions are common
For many reasons, which are still being studied, being first misdiagnosed with different diseases is common among AS patients. For one thing, lower back pain is an extremely common medical complaint, so people likely seek medical attention with a primary care doctor or use care providers like chiropractors or physical therapists to manage their symptoms. When AS presents with many symptoms aside from lower back pain, it may also be overlooked as a potential cause. In a study of CreakyJoints members presented in 2018 at the Annual European Congress of Rheumatology, patients reported seeing a number of different types of health care providers during their diagnosis journey, including general practitioner (87%), rheumatologist (65%), orthopedist (27%), chiropractor (26%), and urgent care/emergency room doctor. Common misdiagnoses included general back problems, psychosomatic issues, sciatica, anxiety/depression, and fibromyalgia.