Ankylosing spondylitis query


Q: Good day.
My name is Osama Mohsen and i am a general practitioner physician. I want to inquire about the possibility of me having ankylosing spondylitis. I am 27 years old. My physical findings are as follows:
- Back pain most profound in the thoracic and middle area. For almost a year now. Gets better by doing some back exercises and sports. constant with little response to NSAIDS. Most painful location is around the right scapula with a trigger tender point on the bone itself. Muscles are constantly in pain and as told by my chiropractor there is some muscle stiffness and fibrosis from prolonged pain. I have limited spine mobility on extension and trying to fully extend produces pain in the thoracic area. I have no lower back pain at the moment but on two separate occasions I experienced sever unilateral hip pain on movement almost mistaken for bone pain it was brief and responded to NSAIDS and rest.
- I have bilateral trigger points at both heels for almost 8 months now. I used to think of it as plantar fasciitis since i am a little overweight and i used to run daily for 20 minutes, but as far as I know it is usually a unilateral disease and bilateral involvement warrants investigating for ensthesitis.
- Family history : nothing relevant except Hashimoto's in my mother.
- Routine lab : only significant for increased CRP (12).
- X-ray sacroiliac : normal.
- X-ray lumbar report: preserved alignment of lumbar spine with signs of severe muscle spasms of the back and loss of normal lumbar lordosis.

I would like to ask about my chances of having AS and if i need MRI or it will be a waste of time and money. Thank you for your precious time.

Kind regards,
Osama Mohsen, MD

Symptoms:  Back pain, bilateral heel pain.

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