Ankylosing Spondylitis

What are the different types of ankylosing spondylitis tests used to screen, diagnose, and monitor the condition? 
 
The Ankylosing spondylitis tests can give you an accurate reading of your markers for inflammation, including Antinuclear antibodies (ANA) and elevated C-reactive protein (CRP) levels. 

Order from Ulta Lab Tests and get your results sent confidentially online. 

In the guide below the list of tests, we explain and answer your questions on Ankylosing Spondylitis Tests.


Name Matches
HLA-B27 is found in 90% of patients with ankylosing spondylitis and 80% in Reiter's disease. Ankylosing spondylitis affects 1 in 1000 caucasians. Ankylosing spondylitis is 10 times more common among individuals with HLA-B27 compared to individuals without this antigen.

Clinical Significance

This test is used in the evaluation of genetic risk for Ankylosing Spondylitis, uveitis, and several other autoimmune disorders.

esult
Code
Result Name LOINC Code Component Name
86000639 HLA-B27 26043-0 HLA-B27

A Complete Blood Count (CBC) Panel is used as a screening test for various disease states including anemia, leukemia, and inflammatory processes.

A CBC blood test includes the following biomarkers: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)

NOTE: Only measurable biomarkers will be reported.

Reflex Parameters for Manual Slide Review
  Less than  Greater Than 
WBC  1.5 x 10^3  30.0 x 10^3 
Hemoglobin  7.0 g/dL  19.0 g/dL 
Hematocrit  None  75%
Platelet  100 x 10^3  800 x 10^3 
MCV  70 fL  115 fL 
MCH  22 pg  37 pg 
MCHC  29 g/dL  36.5 g/dL 
RBC  None  8.00 x 10^6 
RDW  None  21.5
Relative Neutrophil %  1% or ABNC <500  None 
Relative Lymphocyte %  1% 70%
Relative Monocyte %  None  25%
Eosinophil  None  35%
Basophil  None  3.50%
     
Platelet  <75 with no flags,
>100 and <130 with platelet clump flag present,
>1000 
Instrument Flags Variant lymphs, blasts,
immature neutrophils,  nRBC’s, abnormal platelets,
giant platelets, potential interference
     
The automated differential averages 6000+ cells. If none of the above parameters are met, the results are released without manual review.
CBC Reflex Pathway

Step 1 - The slide review is performed by qualified Laboratory staff and includes:

  • Confirmation of differential percentages
  • WBC and platelet estimates, when needed
  • Full review of RBC morphology
  • Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
  • significant findings
  • If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments

Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:

  • Immature, abnormal, or toxic cells
  • nRBC’s
  • Disagreement with automated differential
  • Atypical/abnormal RBC morphology
  • Any RBC inclusions

Step 3 If any of the following are seen on the manual differential, a Pathologist will review the slide:

  • WBC<1,500 with abnormal cells noted
  • Blasts/immature cells, hairy cell lymphs, or megakaryocytes
  • New abnormal lymphocytes or monocytes
  • Variant or atypical lymphs >15%
  • Blood parasites
  • RBC morphology with 3+ spherocytes, RBC inclusions, suspect Hgb-C,
  • crystals, Pappenheimer bodies or bizarre morphology
  • nRBC’s

Increased CRP levels are found in inflammatory conditions including: bacterial infection, rheumatic fever, active arthritis, myocardial infarction, malignancies and in the post-operative state. This test cannot detect the relatively small elevations of CRP that are associated with increased cardiovascular risk.

Useful in differentiating inflammatory and neoplastic diseases and as an index of disease severity. CRP is also useful in monitoring inflammatory disease states.


Ankylosing Spondylitis affects approximately 0.2-0.5% of the population in the US. There is a prevalence of Ankylosing Spondylitis in patients who are positive for the HLA-B27 gene. 

The precise cause of Ankylosing Spondylitis is currently unknown. There are ongoing advancements in research, as well as Ankylosing Spondylitis tests. This helps to better understand this inflammatory disease and treatments.

Read on to learn more about Ankylosing Spondylitis and the effects it has on the body.

What Is Ankylosing Spondylitis?

Ankylosing Spondylitis is a long-term, chronic condition. It causes inflammation in the spine and other parts of the body.

Over time, the inflammation can cause new bone to form. This can lead to the small bones in your spine fusing, causing pain, stiffness, and hunching.

Symptoms can start in teenagers and early adults. This inflammatory disease is more common in men than women. 

Types of Ankylosing Spondylitis

There are 7 different types of Ankylosing Spondylitis:

Enteropathic Arthritis (EnA)

Along with the typical symptoms, this also includes inflammatory bowel disease. The typical diseases are Crohn's, undifferentiated colitis, and ulcerative colitis.

There are other symptoms included. Such as abdominal pain, weight loss, chronic diarrhea, and/or blood in the stool. 

Juvenile Spondyloarthritis (JSpA)

This is when the symptoms of Ankylosing Spondylitis begin in childhood. They may also look to the other types of Ankylosing Spondylitis for diagnosis. 

Psoriatic Arthritis (PsA)

Causes frequent pain and swelling in the smaller joints of the hands and feet. Most will also have a psoriasis rash and swelling in the digits. 

Reactive Arthritis (ReA)

You will start with infections in the intestines and urinary tract. Then the inflammation will start to dominate. Inflammation can occur in the mucus membranes, bladder, skin, eyes, joints, and genitals.

This can cause recurrent symptoms and subsides in 3-12 months. This tends to recur over time, and most patients will develop chronic forms of arthritis over time.

Undifferentiated Spondyloarthritis (USpA)

USpA doesn't fit within the other categories above.

They may have heel pain, knee swelling, and iritis. There is a lack of back pain, infections, intestinal symptoms, and psoriasis. 

Axial Spondyloarthritis (AxSpA)

One of the two newer forms of Ankylosing Spondylitis. It causes inflammation in the hips and/or spine, causing inflammatory back pain.

Peripheral Spondyloarthritis (pSpA)

This form causes inflammation across joints and tendons outside of the spine and sacroiliac joints.

Affected areas include the shoulders, knees, ankles, feet, wrists, hands, and elbows. This can also cause inflammation of the tendons and ligaments, especially in the bones, fingers, and toes.

Almost everyone that has Psoriatic Arthritis will have this category of disease. Patients with the other categories may fit into this category also.

Symptoms of Ankylosing Spondylitis

The most common symptoms which are not categorized as above are:

Back Pain and Stiffness

The back pain and stiffness can feel worse in the early hours of the morning. Symptoms may improve with warmth or gentle exercise and movement.

You may find you are waking in the early hours in a lot of pain and unable to get back to sleep.

Early Stage Symptoms

In the very early stages, some have a mild fever, loss of appetite, and discomfort. 

You may find symptoms started around your teenage years or early 20s. 

Inflammation

Inflammation can be in the spine and pelvis, also other areas such as joints. 

Areas that can have inflammation are the shoulders, heels, hips, and ribs. You may find there is inflammation in the small joints of the hands and feet.

Pain and Discomfort

As there are areas of inflammation in the body, this can also cause pain.

Swelling and heat from the areas may happen, especially in the smaller joints such as fingers.

The pain is more common in the early hours of the morning. Or after a period of time staying still.

Spinal Fusion

Over time, the spine may start to fuse together, giving a hunch-back appearance. You may need surgery long-term.

Diagnosis

A visit with a Rheumatologist is the first step in your diagnosis of Ankylosing Spondylitis.

A physical exam will take place, including imaging tests, MRI, and x-ray scans.

You will also have blood tests performed that are likely to include a test for the HLA-B27 antigen, a test for rheumatoid arthritis, and the following inflammation markers:

1. - Erythrocyte sedimentation rate (ESR), also known as Sed Rate by Modified Westergren (ESR)
2. - C-reactive protein (CRP)
3. - Plasma viscosity (PV)

Your healthcare professional will also check your medical history to understand when the pain and problems started. Blood tests in addition to those noted above may be ordered to understand what is causing the inflammation and identify other conditions such as anemia that may exacerbate arthritis.

A few diagnostic criteria that your healthcare professional will consider along with your lab tests; may vary based on where you live.

  • The onset of pain before 45 years of age
  • Chronic and persistent pain (lasting more than 3 months)
  • Back pain and stiffness, which is worse in the early morning
  • Pain and stiffness easing with movement and exercise
  • Fatigue as well as the presence of inflammation

Other symptoms, such as inflammation elsewhere in the body—particularly the eye and digestive tract will be evaluated.
 

Available Ankylosing Spondylitis Tests

You can order blood tests directly through Ulta Lab Tests to check for Ankylosing Spondylitis. Your tests results are returned quickly in 1 to 2 days for most tests.

The Ankylosing Spondylitis tests most often recommended include the HLA-B27 Antigen TestC-reactive proteinCBC, and an ESR blood test.

The HLA-B27 Antigen Test measures the presence of HLA-B27. Ankylosing spondylitis is ten times more common among individuals with HLA-B27 than individuals without this antigen, and HLA-B27 is found in 90% of patients with ankylosing spondylitis.

The C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) blood tests measure the level of inflammation in your body. While a Complete Blood Count (CBC) is ordered to help rule out other conditions with similar symptoms.

The HLA-B27 DNA Typing test is available to evaluate the genetic risk for Ankylosing Spondylitis, uveitis, and several other autoimmune disorders.

Treating and Managing Ankylosing Spondylitis

From medication to lifestyle changes, there are ways you can manage Ankylosing Spondylitis. Once you have your test results, you can look to managing your condition.

Medications such as NSAIDs (non-steroidal anti-inflammatory drugs) are conventional medications along with DMARDs (disease-modifying antirheumatic drugs). Painkillers can be prescribed to manage pain.

Physical therapy can help you manage the pain and ease the stiffness. Exercise is also another way to relieve the pain and keep your spine mobile.

Lifestyle changes such as a healthy diet and avoiding inflammatory foods. 

Keeping an eye on your inflammation levels is a good way to monitor how your body reacts to the new medications. Blood tests ordered from Ulta Lab Tests are a good way to keep on track without the long waiting periods.

Frequently Asked Questions 

Here are three frequently asked questions about the condition.

Are There Certain Exercises I Should Do?

There are some specific exercises that can help with movement and pain. A physiotherapist will be able to offer advice on the best options for you.

Do I Need to Follow a Special Diet?

There is no specific diet, but having a healthy diet will benefit you long term. It is suggested to avoid nightshades which are inflammatory foods.

Am I Able to Consider Complementary Therapies?

Before you agree to any complementary therapies, seek advice from your specialist. There are complementary therapies such as chiropractic treatment and acupuncture to consider.

Should I Get a Blood Test?

Blood tests are a quick and reliable way to find the answers you need to identify the cause and monitor inflammation's impact on your organs.

You can order the blood tests you are looking for at a low price with Ulta Lab Tests. Our tests are organized by condition so that you can quickly select and order your tests. You can quickly have your specimen collected and receive your results in 24-48 hours for most tests with a local lab.

Testing with Ulta Lab Tests is fast, reliable, and you're able to request any blood test you need, including Ankylosing Spondylitis tests.

If you suspect you have Ankylosing Spondylitis, find peace of mind by testing for Ankylosing Spondylitis with Ulta Lab Tests. There's no need to wait weeks for an appointment at your doctor's office, go back and forth from the doctor to the lab, or worry about scheduling a second appointment to get your test results.

Ulta Lab Tests make it easy to get blood tests. Order the lab tests needed to help diagnose Ankylosing Spondylitis and to monitor your condition.

You order your tests, and we will do the rest.