Difference between Axial Arthritis and Ankylosing Spondylitis?

elcamino · March 13, 2006, 2:10pm

I understand that with IBD, which is a potential diagnosis for me, that you can have either axial arthritis of the spine, or peripheral arthritis of the hands and feet. The joints that are involved with me are my hips, shoulders, neck, knees, ankles, hands, and sometimes feet, including the heels. The most consistently painful joints are the hips and shoulders and neck. To me, that sounds like axial arthritis, not peripheral. When you read about axial arthritis, you find a lot of stuff out there on Ankylosing Spondylitis (AS). From what I've read, however, AS much more common in males, but it does often develop in concert with IBD. One source I read stated that females can get it, but it's manifested in different ways. With a male, the most common and painful symptom is lower back pain. With females, symptoms often arise in the hips, shoulders, and neck. Do I have AS? And what is the difference between axial arthritis and AS, or are they one and the same?

Ides_girl · March 13, 2006, 10:25pm

Elcamino, hope you don't mind me waying in on this. I was first diagnosed with the typical peripheral arthritis associated with Crohn's Disease and Ulcerative Colitis. My rheumy wrote spondyloarthropathy with enthesitis and said this was the arthritis associated with IBD. He knew at this time that I was HLA B27 positive. While being HLA B27 positive with symptoms does not always mean AS, it usually does. My peripheral involvement continued to worsen. It was the Achilles tendon inflammation and plantar fasciitis, and the calcification of the shoulder tendons and then the Achilles, that changed the situation. Additionally, once the CD was in remission, the arthritis continued to flare. AS runs a course independent of the IBD. The arthritis associated with IBD waxes and wanes with the course of the inflammatory bowel disease activity. I now have the Ankylosing Spondylitis diagnosis.

The Spondylitis Association of America site has a message board. One of the frequent discussions is the difficulty women have getting diagnosed because so many believe AS to be a "man's disease." And you are correct - women can present differently with this disease.

The fact that you have a low RF could be meaningful. I have read of others that have false positive RFs and their RF is always low. I am not well versed in RA so will let others answer those questions.

Have you had an MRI of the SI joints or the cervical area? Have you had a HLA B27 test?

CD, Ankylosing Spondylitis, connective tissue disease,

asthma, PAD, peripheral neuropathy

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elcamino · March 14, 2006, 12:20am

Hi Ides, your information and opinions are always welcome! I have not had an MRI of anything yet; nor have I been tested for HLA-B27. Rheumatologist feels I have the enteropathic arthritis. If my colitis goes into remission, the arthritis should resolve itself. Interestingly, however, my colonoscopy of a few weeks ago showed a clean colon, no inflammation or ulcers. I also have very few lower GI symptoms right now. My arthritis continues to worsen, and at the very least, is persistent from one day to the next. I intend on discussing this with my rheumatologist when I see him in a few weeks.

I discussed the low positive RF with him. He says it is meaningful because of my joint pains and because of my age--I'm only 38. The only false positives he's aware of are with just a few older people (age 65+). I know that a low positive RF is implicated in other things besides RA (which I'm fairly sure I don't have)--SLE, Scleroderma, mixed connective tissue disease. It hasn't been lost on me that my mother also had a low positive RF and was eventually diagnosed with mixed connective tissue disease. But it took years of joint pains before she developed any other symptoms.

I was simply wondering if RF is implicated in IBD, although most IBD-related arthritis is sero-negative?

Elcamino