It can take many years from when you first notice symptoms to when you finally get a spondylitis diagnosis. The average length of time is seven to eight years.
Why?
First, it’s important to see a specialist such as a rheumatologist as soon as you can when you have active inflammation symptoms. Rheumatologists are trained to detect, diagnose and treat this type of back pain.
Second, most types of healthcare providers, particularly primary care doctors, struggle to recognize inflammatory back pain. This is especially so when it comes to distinguishing it from mechanical back pain.
Another thing that makes getting a diagnosis for inflammatory arthritis difficult is that it can take a long time for telltale changes in your sacroiliac joint to show up on x-rays. Luckily, new MRI technology makes it much easier to spot. In fact, MRIs can identify four types of active inflammation that may be present in spondylitis. Below are the descriptions.
Symptoms of osteitis include are similar to any type of inflammation and include pain, and occasionally redness and swelling of the overlying skin.
When talking about sacroiliitis and spondyloarthritis it may be important to note that, first, signs of osteitis on an MRI likely definitively indicates that you have these bony changes, and that second, there is an early stage osteitis and a late stage osteitis.
The characteristics of osteitis at the sacroiliac joints are very different at each stage. Of course, it’s important to catch the signs early so that you give your treatment the best possible chance to work for you and help you manage the pain and/or disability.
That said, enthesitis is generally felt in the heels and sometimes the knees, although it can lead to swelling and soreness in the upper body and/or pelvis, as well. Enthesitis is related to diffuse idiopathic skeletal hyperostosis (acronym DISH) which is a condition related to aging in which spinal ligaments harden. It may also occur along with diseases such as systemic lupus erythematous or sarcoidosis.
Enthesitis often causes the affected area of the soft tissue to become ropey (called fibrosis) and/or solid (called calcification or ossification). It can be quite painful; the pain occurs mainly when you use your muscles and they pull on your bones.
Synovitis is common in arthritis. Symptoms may include pain when you move the affected part and swelling. If you have synovitis, your healthcare provider may suggest or prescribe NSAIDs to control the inflammation and pain.
