Bechterew's Disease - Diagnosis

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-11-27 18:19

Bechterew's disease: diagnosis

Back pain is a common ailment and can have various causes. Often they are not taken very seriously at the beginning. This is the main reason why on average several years pass between the first symptoms and a confirmed ankylosing spondylitis diagnosis. If patients under the age of 45 have chronic back pain (lasting more than three months), rheumatological clarification should be sought.

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• How is the diagnosis made?
• Whom can I ask?
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How is the diagnosis made?

For the early detection of ankylosing spondylitis (other names are ankylosing spondylitis, ankylosing spondylitis or axial spondyloarthritis), the most important part of the diagnosis is the precise anamnesis. It is important to recognize suspicious factors at an early stage, such as:

• positive family history of ankylosing spondylitis or its comorbidities,
• inflammatory back pain,
• Inflammation of the joints (arthritis),
• Psoriasis,
• chronic inflammatory bowel disease,
• Irisitis,
• Inflammation of tendons and muscles.

The physical exam focuses primarily on the spine and joints. However, attention must also be paid to any signs of an accompanying illness that may already be present. In the early phase, there are indications of current and past inflammations on the sacrum joints and the spine using magnetic resonance imaging. If typical changes in the sacrum or the spine, such as bridges (syndesmophytes) between the vertebral bodies, can be detected in conventional X-rays, the stage is already at an advanced stage.

A blood test will determine whether there are increased inflammation values (blood sedimentation, CRP). In Bechterew's disease, however, they can also be in the normal range or only slightly increased. A positive detection of the genetic marker HLA-B27 is - exclusively in combination with other clinical features of the disease - an important diagnostic aid. On its own, however, a positive result is not synonymous with a diagnosis of Bechterew's disease, as HLA-B27 also occurs in many people without this disease (around eight percent). So there are many more (more than ten times as many) HLA-B27-positive people in Austria without ankylosing spondylitis.

With the help of special measuring methods, the mobility of the spine and thoracic expansion as well as posture can be assessed and controlled. Above all, they show the extent of the stiffening or changes in posture and provide information on which movement exercises should be used specifically. The measured values are documented and provide information about the effectiveness of the therapies and the course of the disease.

Whom can I ask?

Bechterew's disease is present in around five to ten percent of chronic back pain (lasting more than three months). If they appear for the first time before the age of 45 and especially when they are at rest or at night, a rheumatological investigation should definitely be carried out.

The following contact persons are available for the diagnosis and comprehensive assessment of the symptoms:

• Family doctor,
• Rheumatologist.

How are the costs going to be covered?

The e-card is your personal key to the benefits of the statutory health insurance. All necessary and appropriate diagnostic and therapeutic measures are taken over by your responsible social insurance agency. A deductible or contribution to costs may apply for certain services. You can obtain detailed information from your social security agency. Further information can also be found at:

• Right to treatment
• Visit to the doctor: costs and deductibles
• What does the hospital stay cost?
• Prescription fee: This is how drug costs are covered
• Medical aids & aids
• Health Professions AZ

and via the online guide to reimbursement of social insurance costs.