Could My Symptoms Indicate Ankylosing Spondylitis?

Ankylosing spondylitis?

Hello Dr.
Lee, thank you for taking the time to respond despite your busy schedule.
Here are my symptoms:
1.
In mid-September, I felt a warm and tight sensation under my left rib (upper left abdomen), as if a strap was wrapped around it, which was very uncomfortable.
At the same time, my left groin area (hip joint?) also felt warm and swollen.

2.
Later, the tight sensation in my upper left abdomen radiated to my right back, where I felt a tingling warmth, and I experienced a feeling of pressure in my chest while breathing.
I also felt a sense of tightness in my lower back when bending over.

3.
At the beginning of October, the feeling of pressure extended downward, and then I experienced severe pain in my lumbar region, making it difficult to sit or stand comfortably.
I visited an orthopedic clinic where the doctor used ultrasound and noted that the ligaments in my lower back were swollen.
An X-ray of my spine revealed that it was straight and lost its elasticity, unlike the normal curvature seen in most individuals from the side.

4.
In November, I went to the hospital's orthopedic department to address the tight sensation under my left rib.
The doctor diagnosed it as fascia inflammation, possibly caused by poor posture, and did not perform ultrasound or X-ray imaging.

5.
As of now, my lower back is still uncomfortable.
I feel stiffness and tightness in my spine and back muscles when squatting, bending, or breathing.
Particularly when squatting, it feels as if I need to stretch my spine segment by segment, which is very uncomfortable.
This symptom has been troubling me for three months, and the discomfort in my spine has made me feel quite unwell and low in mood.
I am wondering if this could be a symptom of ankylosing spondylitis.
I hope you can provide me with some advice.
Thank you!

Xiao Yi, 20~29 year old female. Ask Date: 2018/12/14

Dr. Li Yongheng reply Orthopedics

Based on the symptoms mentioned, the likelihood of myofascial inflammation is the highest.
It does not resemble the symptoms of ankylosing spondylitis, and a blood test for HLA-B27 can diagnose ankylosing spondylitis.
It is recommended that you visit a rheumatology clinic for examination to rule out autoimmune diseases.

Reply Date: 2018/12/14

More Info

Based on your symptoms and medical history, it is indeed possible that you may be experiencing signs of Ankylosing Spondylitis (AS). AS is a type of inflammatory arthritis that primarily affects the spine and can lead to severe, chronic pain and discomfort in the back and joints. It is characterized by inflammation of the spinal joints (sacroiliitis), which can result in pain and stiffness in the lower back and hips.
Your description of the sensations in your left upper abdomen and groin, along with the subsequent feelings of tightness and discomfort in your back and chest, could be indicative of the inflammatory processes associated with AS. The fact that you have experienced a loss of spinal curvature, as noted in your X-ray findings, is also a significant factor. A straightened spine can be a hallmark of AS, as the disease can lead to fusion of the vertebrae over time, resulting in a rigid spine.

The symptoms you describe—such as the tightness around your ribcage, the heat sensation, and the discomfort when bending or sitting—are consistent with the musculoskeletal manifestations of AS. Additionally, the stiffness and pain that worsen with inactivity and improve with movement are classic symptoms of this condition.
It is also worth noting that AS can sometimes be associated with other conditions, such as uveitis (inflammation of the eye), which you may want to discuss with your healthcare provider, especially given your history of autoimmune conditions.
Given the duration of your symptoms (three months) and their impact on your daily life, it is advisable to pursue further evaluation. A referral to a rheumatologist would be beneficial, as they specialize in autoimmune and inflammatory diseases. They may recommend additional imaging studies, such as MRI, which can provide more detailed information about the sacroiliac joints and any inflammation present. Blood tests for specific markers, such as HLA-B27, can also aid in the diagnosis, as a significant percentage of individuals with AS test positive for this antigen.

In the meantime, physical therapy can be an effective way to manage symptoms and improve mobility. Engaging in regular exercise, particularly activities that promote flexibility and strength, can help alleviate stiffness and improve your overall function. Nonsteroidal anti-inflammatory drugs (NSAIDs) may also be prescribed to help manage pain and inflammation.

Lastly, it’s important to address the emotional toll that chronic pain can take on your mental health. Seeking support from mental health professionals or support groups can be beneficial in managing the psychological aspects of living with a chronic condition.

In summary, your symptoms do align with those of Ankylosing Spondylitis, and it would be prudent to seek further evaluation from a specialist. Early diagnosis and intervention can significantly improve outcomes and quality of life for individuals with AS.

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