There is no sure-fire way to diagnose Ankylosing Spondylitis like how you would diagnose a broken bone with an x-ray, or how you would diagnose high blood pressure with a sphygmomanometer. However, we can use a combination of case history taking, blood tests, and imaging to make an informed decision quite confidently. If anything, it is actually often missed, particularly at the early stages.
So what do we look for? Well, the signs and symptoms outlined above essentially. There have been tools developed to fasttrack patients with potential Axial Spondyloarthritis to see a rheumatologist (a doctor that deals with inflammatory/autoimmune problems), such as the SPADE tool, which is mainly used by first contact health care practitioners like osteopaths, GPs, or physiotherapists. Looking for clues during the case history, physical examination, and blood tests are the key to reaching a diagnosis.
One of the known patterns of Ankylosing Spondylitis is that it tends to develop in men more often than women, around 2.5 times more likely. However, do you remember there’s another subgroup called non-radiographic axial spondyloarthritis? Well for those who don’t have late-stage imaging changes such as the “bamboo spine” or “dagger spine”, the prevalence of non-axial spondyloarthritis is actually about the same between men and women. This can suggest there’s a lot of females with non-radiographic axial spondyloarthritis who may not be aware of it.