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Ankylosing Spondylitis Specialist Visit: What to Expect

Reviewed by Michael W. Smith, MD on November 24, 2020

When it's time to see a specialist for ankylosing spondylitis (AS), you'll make an appointment with a rheumatologist.

A rheumatologist is a doctor who focuses on diseases that affect your joints, muscles, and bones. They treat all types of arthritis, including AS.

Why See a Rheumatologist?

Because AS is a long-lasting condition, you'll need to manage it for the rest of your life. A specialist who knows about AS can help you find the treatments and management strategies that work best for you.

The goal of AS treatment is to:

  • Lessen stiffness and pain
  • Help you keep moving
  • Keep your AS from getting worse

Prepare for Your Visit

To make the most of your time with the doctor, come prepared with information. Be ready to talk about:

  • Your AS symptoms. Be as specific as possible -- where the pain or stiffness is, when you usually get it, how long it lasts, etc.
  • Any medications you take and any you're allergic to
  • Other health problems you've had
  • Your family medical history

If you've had previous X-rays or MRIs of the affected area, bring copies with you. Or ask the doctor who did them to send them to the rheumatologist's office.

Questions to Ask

To make sure you understand your diagnosis and treatment, bring some questions for your rheumatologist as well.

Ask your doctor if it's OK for you to record their responses on your phone. Or take written notes.You might ask:

  • What's the best way to treat my pain?
  • Will changing my diet help ease my symptoms?
  • How can I be more comfortable when I sleep?
  • Will my AS get better or worse?
  • Will I get other problems because of AS?
  • How long before I see results from treatment?
  • Who else should be on my health care team?
  • Are there any activities I can't do?
  • How often should I have follow-up appointments?
  • What can I do about side effects from medications?

 

What to Expect

Your first appointment is likely to take an hour or more. Your doctor will consider your symptoms along with the results of imaging tests. To better understand your symptoms, they may ask:

  • When did your pain start?
  • How often are you in pain?
  • What makes it worse?
  • Does your pain get better when you are active?

Continued

The rheumatologist will likely give you a physical exam to find out how well your spine and joints move, how much your chest expands, and whether certain movements cause pain. You may be asked to:

  • Bend in different directions
  • Take deep breaths
  • Move your legs and hips in a range of positions

You may get imaging tests like X-rays or an MRI. This can tell the rheumatologist whether you have inflammation in the sacroiliac joints in your lower spine. That's a telltale sign of AS.

Your rheumatologist might do a blood test to look for markers of inflammation. They could also test your blood for the gene HLA-B27, which more than 95% of people with AS carry.

WebMD Medical Reference

Sources

SOURCES:

American College of Rheumatology: "What is a Rheumatologist?"

Cleveland Clinic: "3 Tips to Make the Most of Your First Rheumatology Appointment."

Mayo Clinic: "Ankylosing Spondylitis."

Ankylosing Spondylitis: "A Guide to Your First Rheumatology Appointment."

John Hopkins Medicine: "Ankylosing Spondylitis."

Arthritis Foundation: "Questions to Ask Your Doctor: Axial Spondyloarthritis."

American College of Rheumatology: "What to Expect at Your First Visit with A Rheumatologist."

University of Washington Orthopaedics and Sports Medicine: "Ankylosing Spondylitis."

Arthritis and Rheumatology Clinics of Kansas: "Ankylosing Spondylitis."

Joerg Ermann, MD, associate physician, Brigham and Women’s Hospital Division of Rheumatology, Immunology, and Allergy, Boston.

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