ankylosing spondylitis?

rlh2000

I've been battling hip/SI pain for a couple months now, and after thinking it was on the mend and starting to come out of run jail, it is back and very angry.  Coinciding with this, I've also had a lot of thoracic spine pain and stiffness, where lying on my back when it is bad really hurts, and taking a deep breath feels like an uncomfortable stretch in my ribcage and spine.  The two seem to modulate together- when the hip is bad, so is the thoracic spine, and then when the hip is feeling better, the spine does too.  Now I know there are a zillion reasons that could be causing this, but I have Crohn's disease and when I mentioned it to my gastroenterologist this morning, he thinks I need a full workup for ankylosing spondylitis (AS).  This has been at the back of my mind as a possibility, since it is common in folks with Crohn's or colitis, but I didn't want to jump to worse case scenario.  My GI is ordering an MRI of spine and hip, which is probably the next step regardless of what it is, since I don't seem to be responding fully to rest and PT. 

 As a PT, I've treated a couple folks with AS, and while they were probably on the more severe side of the spectrum, I am terrified right now.  I know I shouldn't even think about it til I know, but wondering if anyone has any experience with this. 

 Like any injury, I'm drowning in uncertainty right now.  Pretty much everything I have on my calendar for the summer is race related, and now that is all up in the air.  And that is regardless of if this turns out to be AS or some other injury, whatever it is I can't seem to really kick it. 

 Anyone got any experience here? Help a girl out!

Robert Sabo

MRI is usually first choice study BUT not so much for AS. Xray or CT to see if joints are fused might be better, but I am a spine surgeon and AS is rarely a surgical problem. Rheumatologist is probably best to evaluate and treat and I do believe there is medication for this. If yur neck is involved there may be increased risk of injury if you get in a bike accident. Don't want to be negative but do want to warn you. Don't worry till you know.

Satish Punna

I would wait until you get your imaging and workup done before you panic.  

Also, although AS and enteropathic spondyloarthropathy (the kind associated with Crohn/IBD) are in the same family of seronegative spondyloarthropathy they are different diseases with diverse manifestations.  The ankylosing part for instance I don't believe is very common with enteropathic spondyloarthropathy. 

rlh2000

Finally got a read on the MRI and all clear! Sooo relieved! While I most definitely did not want it to be AS, it is somewhat frustrating that I still don't know why I'm having pain. But still, definitely happy dance!