Ankylosing spondylitis is diagnosed first through a physical examination, in which a doctor will take a thorough medical history and note symptoms that are consistent with ankylosing spondylitis.
The doctor will likely order an X-ray, which can show changes in the spine and joints that indicate ankylosing spondylitis. Other diagnostic tests include:
Magnetic resonance imaging (MRI): An MRI uses magnetic fields and radio-frequency waves to create an image of the spine, and can reveal the details of the disc, the nucleus (the jelly-like substance within) and the annulus (the firm outer layer). An MRI scan can also show evidence of previous injuries that may have healed and other details in the spine that can’t normally be seen on an x-ray.MRIs, which show the softer tissues, can detect the disease earlier than X-rays.
Blood tests: Blood is tested for the HLA-B27 gene, which is carried by more than 95 percent of those with ankylosing spondylitis.
Many cases of ankylosing spondylitis are treated without surgery. These treatments may include anti-inflammatory drugs (NSAIDs), steroids, and drugs that are used to treat rheumatoid arthritis such as methotrexate and sulfasalazine.
Physical therapy is almost always part of the treatment. Patients are given daily exercises for strengthening and stretching, along with deep breathing and posture exercises.
If the disease has progressed to the point that daily activities are severely impaired, then surgery may be an option, including joint replacement surgery (see Surgery for Ankylosing Spondylitis).
At Weill Cornell Medicine Neurological Surgery, our specialists have advanced training in diagnosing and treating conditions of the spine.
Reviewed by: Eric Elowitz, MD
Last reviewed/last updated: September 2020