{"id":1683,"date":"2023-07-31T21:04:44","date_gmt":"2023-07-31T15:34:44","guid":{"rendered":"https:\/\/adultserviceau.com.au\/blog\/why-it-takes-so-long-to-diagnose-ankylosing-spondylitis\/"},"modified":"2023-07-31T21:04:44","modified_gmt":"2023-07-31T15:34:44","slug":"why-it-takes-so-long-to-diagnose-ankylosing-spondylitis","status":"publish","type":"post","link":"https:\/\/adultserviceau.com.au\/blog\/why-it-takes-so-long-to-diagnose-ankylosing-spondylitis\/","title":{"rendered":"Why It Takes So Long to Diagnose Ankylosing Spondylitis"},"content":{"rendered":"<p> [ad_1]<br \/>\n<\/p>\n<div data-page=\"1\">\n<section>\n<div id=\"em-image-1\" class=\"middle\" ref=\"em-image-1\">\n<aside data-e2e=\"ia-image\" align=\"middle\" class=\"ia-module-container ia-image middle\" data-metric-module=\"ia-img-soc\">\n<figure>\n<div class=\"main\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/img.wbmdstatic.com\/vim\/live\/webmd\/consumer_assets\/site_images\/article_thumbnails\/other\/doctor_examining_patient_with_back_pain_other\/1800x1200_doctor_examining_patient_with_back_pain_other.jpg?resize=650:*\" alt=\"\" style=\"height:auto;\"\/>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><figcaption>\n<\/figcaption><\/figure>\n<\/aside><\/div>\n<p>\u00a0<\/p>\n<p>Carlos Julio Aponte, MD, still remembers his <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/ankylosing-spondylitis\/what-is-ankylosing-spondylitis\">ankylosing spondylitis<\/a> (AS) patient No. 1. The man, a former traffic controller, was referred to Aponte more than 4 decades ago, racked by such agonizing back pain since age 20 that he couldn\u2019t hold a job. No one could pinpoint the source of the man\u2019s \u201cmysterious\u201d ailment. One doctor suspected that the patient\u2019s symptoms were all in his head and <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/drugs\/index-drugs.aspx\" data-crosslink-type=\"article\">prescribed medication<\/a> for that.<\/p>\n<p>Aponte, a <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/rheumatoid-arthritis\/rheumatologist-ra-doctor\" data-crosslink-type=\"article\">rheumatologist<\/a> in Cleveland, asked his new patient when his back pain was the worst. In the morning, he replied. In fact, it took the man almost 2 hours to get out of bed and on his <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/pain-management\/guide\/foot-pain-causes-and-treatments\" data-crosslink-type=\"article\">feet<\/a>.<\/p>\n<p>\u201cI said, \u2018Oh my god, you have ankylosing spondylitis!\u2019 \u201d Aponte recalls.<\/p>\n<p>Doctors today understand much more about inflammatory diseases like AS than they did in the 1970s. But even then, Aponte knew that morning stiffness that lasts more than an hour could be a telltale sign of AS.<\/p>\n<\/section>\n<section><pagebreak\/>\n<p>The most common complaint with AS is <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/back-pain\/ss\/slideshow-back-pain-myths\" data-crosslink-type=\"slideshows\">back pain<\/a>, something almost all of us have at one point or another. But the disease, a type of arthritis that mainly affects the spine, is very rare; out of 1,000 Americans, just two to five people may have it.<\/p>\n<div id=\"em-image-3\" class=\"left\" ref=\"em-image-3\">\n<aside data-e2e=\"ia-image\" align=\"left\" class=\"ia-module-container ia-image left\" data-metric-module=\"ia-img-soc\">\n<figure>\n<div class=\"main\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/img.wbmdstatic.com\/vim\/live\/webmd\/consumer_assets\/site_images\/article_thumbnails\/other\/journeys_as_feature_on_diagnosis_challenges_other\/280x340_jouneys_as_feature_diagnosis_challenges_david_borenstein_other.jpg?resize=300:*\" alt=\"David Borenstein, MD, George Washington University Medical Center\" style=\"height:auto;\"\/>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><figcaption>\n<p class=\"module_description\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tDavid Borenstein, MD, George Washington University Medical Center\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n<\/figcaption><\/figure>\n<\/aside><\/div>\n<div id=\"em-pullquote-4\" class=\"right\" ref=\"em-pullquote-4\">\n<aside data-e2e=\"ia-pull-quote\" id=\"ia-pull-quote\" align=\"right\" class=\"ia-module-container ia-pull-quote right\">\n<blockquote class=\"pq-wrapper\">\n<p class=\"pq-title\">\n\t\t\t\t\t\t\t\t\t\t\t\t\tDetecting AS is not unlike rooting around for a &#8216;needle in the haystack.&#8217;\n\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t<small class=\"pq-description\"><br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\tDavid Borenstein, rheumatologist<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/small>\n\t\t\t\t\t\t\t\t\t\t\t<\/p><\/blockquote>\n<\/aside><\/div>\n<p>Despite recent medical advances, studies suggest the time from the start of AS symptoms to an accurate diagnosis still spans an average of 7-10 years. For one thing, the damage in the sacroiliac joints, which link your pelvis and low back, shows up on X-rays only in the later stages<\/p>\n<p>AS also shows up differently in different people, says David Borenstein, MD, a rheumatologist and clinical professor of medicine at the George Washington University Medical Center. What\u2019s more, there is no single, definitive diagnostic test for AS. So detecting the disease, Borenstein says, is not unlike rooting around for \u201ca needle in the haystack.\u201d<\/p>\n<\/section>\n<section>\n<p>\u00a0<\/p>\n<div id=\"em-image-5\" class=\"left\" ref=\"em-image-5\">\n<aside data-e2e=\"ia-image\" align=\"left\" class=\"ia-module-container ia-image left\" data-metric-module=\"ia-img-soc\">\n<figure>\n<div class=\"main\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/img.wbmdstatic.com\/vim\/live\/webmd\/consumer_assets\/site_images\/article_thumbnails\/other\/journeys_as_feature_on_diagnosis_challenges_other\/280x340_jouneys_as_feature_diagnosis_challenges_don_markham_other.jpg?resize=300:*\" alt=\"Don Markham\" style=\"height:auto;\"\/>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><figcaption>\n<p class=\"module_description\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tDon Markham\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n<\/figcaption><\/figure>\n<\/aside><\/div>\n<p>By Don Markham\u2019s count, it took him about 7 years to confirm that AS was responsible for his serious eye <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/arthritis\/about-inflammation\" data-crosslink-type=\"article\">inflammation<\/a> called <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/eye-health\/uveitis-16\/uveitis-inflammation-eye\" data-crosslink-type=\"article\">uveitis<\/a>. But when the 47-year-old Dallas native looks back, he thinks the correct answer actually may be closer to 30 years.<\/p>\n<\/section>\n<\/div>\n<div data-page=\"2\">\n<section>\n<p>Markham remembers his mother strapping soothing hot towels on his knees when he was 10. The flares of <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/pain-management\/default.htm\" data-crosslink-type=\"article\">pain<\/a> would come and go. But those childhood episodes were mostly dismissed as growing pains. And they didn\u2019t deter Markham from growing up playing football and <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/fitness-exercise\/default.htm\" data-crosslink-type=\"article\">lifting weights<\/a>.<\/p>\n<div id=\"em-pullquote-6\" class=\"middle\" ref=\"em-pullquote-6\">\n<aside data-e2e=\"ia-pull-quote\" id=\"ia-pull-quote\" align=\"middle\" class=\"ia-module-container ia-pull-quote middle\">\n<blockquote class=\"pq-wrapper\">\n<p class=\"pq-title\">\n\t\t\t\t\t\t\t\t\t\t\t\t\tThe best way to describe it is it\u2019s like almost being blind, but you\u2019re not blind.\n\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t<small class=\"pq-description\"><br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\tDon Markham<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/small>\n\t\t\t\t\t\t\t\t\t\t\t<\/p><\/blockquote>\n<\/aside><\/div>\n<p>But around the time Markham turned 40, his life took a scary turn when he got uveitis, a possible complication of AS that affects the <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/eye-health\/picture-of-the-eyes\" data-crosslink-type=\"article\">eyes<\/a>.<\/p>\n<p>\u201cI basically couldn\u2019t see. I could make out shapes, but I was very light-sensitive,\u201d he says. \u201cThe best way to describe it is it\u2019s like almost being blind, but you\u2019re not blind.\u201d<\/p>\n<p>The scare lasted about 6 weeks. Markham\u2019s <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/eye-health\/eye-assessment\/default.htm\" data-crosslink-type=\"tools\">eye<\/a> doctors couldn\u2019t figure out the cause but guessed that it could be \u201csome kind of <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/a-to-z-guides\/autoimmune-diseases\" data-crosslink-type=\"article\">autoimmune disease<\/a>.\u201d Without clear answers, Markham once again chose to \u201cblow it off.\u201d<\/p>\n<\/section>\n<section>\n<p>Several years later, Markham thought he had twisted his left <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/pain-management\/knee-pain\/knee-pain-overview\" data-crosslink-type=\"article\">knee<\/a> while kayaking. His doctor noticed that his \u201c<a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/women\/ss\/slideshow-what-is-inflammation\" data-crosslink-type=\"slideshows\">inflammation<\/a> markers were off the charts.\u201d But once again, the doctors remained baffled. One thought he might have <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/cancer\/default.htm\" data-crosslink-type=\"article\">cancer<\/a>. Another suggested the reason for the pain and spreading inflammation might be neurological.<\/p>\n<div id=\"em-bulletedlist-7\" class=\"right\" ref=\"em-bulletedlist-7\">\n<aside data-e2e=\"ia-bullet-list\" align=\"right\" class=\"ia-module-container ia-bullet-list right\">\n<p class=\"module_title\" style=\"font-weight:bold\">\n\t\t\t\t\t\t\t\t\t\t\t\tLearn more about ankylosing spondylitis\n\t\t\t\t\t\t\t\t\t\t\t<\/p>\n<\/aside><\/div>\n<\/section>\n<section>\n<p>\u201cI don\u2019t know how many diagnoses they tried to come up with, and none of them was correct,\u201d Markham says. He struggled with the effects from his multiplying medications, including <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/schizophrenia\/what-are-hallucinations\" data-crosslink-type=\"article\">hallucinations<\/a>. At one point, \u201cI was almost kind of <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/depression\/depression-recognizing-signs-of-suicide\" data-crosslink-type=\"article\">suicidal<\/a>.\u201d<\/p>\n<p>After consulting nearly three dozen doctors &#8212; but not until a fateful visit to a rheumatologist in Dallas &#8212; Markham finally learned he had AS.<\/p>\n<p>After one look at Markham and his medical history, the rheumatologist said, \u201cI already know what you have, but I need to do a test to confirm it.\u201d<\/p>\n<p>Right away, Markham quit some of his medications and was weaned off others while he started on therapies to help with his AS. His recovery was rapid. He was back to lifting light weights in a few weeks and competing professionally in about a year.<\/p>\n<\/section>\n<\/div>\n<div data-page=\"3\">\n<section>\n<p>Today, Markham\u2019s AS has progressed to the point that his spine is slightly fused. He regrets the time he wasted on incorrect diagnoses.<\/p>\n<\/section>\n<section><pagebreak\/>\n<p>\u201cThe problem is because it all depends on referrals\u201d to specialists, he says. But if a general practitioner has \u201cnever seen AS, how would they know to refer you to a rheumatologist?\u201d<\/p>\n<p>Some people with AS may have symptoms that can come from other conditions. They include pain in the buttocks and heels, <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/skin-problems-and-treatments\/psoriasis\/understanding-psoriasis-basics\" data-crosslink-type=\"article\">psoriasis<\/a>, and gut problems that can look like Crohn\u2019s disease or <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/ibd-crohns-disease\/ulcerative-colitis\/what-is-ulcerative-colitis\" data-crosslink-type=\"article\">ulcerative colitis<\/a>.<\/p>\n<div id=\"em-pullquote-8\" class=\"middle\" ref=\"em-pullquote-8\">\n<aside data-e2e=\"ia-pull-quote\" id=\"ia-pull-quote\" align=\"middle\" class=\"ia-module-container ia-pull-quote middle\">\n<blockquote class=\"pq-wrapper\">\n<p class=\"pq-title\">\n\t\t\t\t\t\t\t\t\t\t\t\t\tFifteen minutes with your patients is just not enough.\n\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t<small class=\"pq-description\"><br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\tCarlos Julio Aponte, rheumatologist<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/small>\n\t\t\t\t\t\t\t\t\t\t\t<\/p><\/blockquote>\n<\/aside><\/div>\n<p>\u00a0<\/p>\n<p>Aponte, the rheumatologist, says many medical appointments are too rushed and unfocused to ferret out unusual diseases like AS.<\/p>\n<p>\u201cFifteen minutes with your patients is just not enough,\u201d Aponte says, adding that good communication is critical, especially for rheumatologists. \u201cI did find a lot of \u2018pearls\u2019 asking the right questions,\u201d he says.<\/p>\n<p>Borenstein, of George Washington University Medical Center, says doctors have gotten much better at identifying the signs of AS and the types of people who can get the disease. AS typically affects older <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/teens.webmd.com\/default.htm\" data-crosslink-type=\"article\">teens<\/a> and young adults, an age when they\u2019re supposed to be at their peak health. Treatments have improved, too.<\/p>\n<\/section>\n<section><pagebreak\/>\n<p>\u201cPeople don&#8217;t need to suffer anywhere near the amount of trouble they&#8217;ve had in the past,\u201d he says.<\/p>\n<p>AS once was thought to be almost exclusively a male disease. That, Borenstein says, led many doctors to overlook the symptoms in women. According to the latest estimates, women and girls account for about a quarter of AS cases. When it comes to a related condition called non-radiographic axial spondyloarthritis (nr-axSpA), the gender breakdown is evenly split.<\/p>\n<\/section>\n<section>\n<div id=\"em-image-9\" class=\"left\" ref=\"em-image-9\">\n<aside data-e2e=\"ia-image\" align=\"left\" class=\"ia-module-container ia-image left\" data-metric-module=\"ia-img-soc\">\n<figure>\n<div class=\"main\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/img.wbmdstatic.com\/vim\/live\/webmd\/consumer_assets\/site_images\/article_thumbnails\/other\/journeys_as_feature_on_diagnosis_challenges_other\/280x340_jouneys_as_feature_diagnosis_challenges_chris_hill_other.jpg?resize=300:*\" alt=\"Charis Ann Hill                                                                               (Photo: Brian Baker)\" style=\"height:auto;\"\/>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><figcaption>\n<p class=\"module_description\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tCharis Ann Hill                                                                               (Photo: Brian Baker)\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n<\/figcaption><\/figure>\n<\/aside><\/div>\n<p>Charis Ann Hill, a 33-year-old from Sacramento, CA, who uses the pronoun &#8220;they,&#8221; was raised by their mother in North Carolina. Their father, who Hill says wasn\u2019t involved in their life, had AS.<\/p>\n<p>\u201cI knew he had a disease that I couldn&#8217;t pronounce the name of,\u201d Hill says. \u201cBut I knew that it wasn&#8217;t going to happen to me because it was a \u2018man&#8217;s disease.\u2019\u201d<\/p>\n<\/section>\n<\/div>\n<div data-page=\"4\">\n<section>\n<p>Some 80%-95% of people with AS carry a gene called human leukocyte antigen B27 (HLA-B27). Children can inherit this gene from their parents. But you can get AS without carrying the gene. And the majority of people who have HLA-B27 don\u2019t get AS.<\/p>\n<\/section>\n<section>\n<p>Hill, a model, was an athletic kid who ran and played soccer. When Hill hit their teens, the pain around their knees and other joints started. But Hill dismissed the symptoms as sports-related aches.<\/p>\n<p>By the time Hill moved to California for college, their \u201cbody started deteriorating.\u201d<\/p>\n<p>One doctor brushed off Hill\u2019s intense low back spasms as sports-related, again. At the time, Hill thought that made sense.<\/p>\n<div id=\"em-image-10\" class=\"middle\" ref=\"em-image-10\">\n<aside data-e2e=\"ia-image\" align=\"middle\" class=\"ia-module-container ia-image middle\" data-metric-module=\"ia-img-soc\">\n<figure>\n<div class=\"main\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/img.wbmdstatic.com\/vim\/live\/webmd\/consumer_assets\/site_images\/article_thumbnails\/other\/understanding_your_spine_journeys_other\/650x974_understanding_your_spine_journeys_other.jpg?resize=650:*\" alt=\"\" style=\"height:auto;\"\/>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><figcaption>\n<\/figcaption><\/figure>\n<\/aside><\/div>\n<p>Hill consulted another doctor, who suggested they had <a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/anxiety-panic\/default.htm\" data-crosslink-type=\"article\">anxiety<\/a> and wrote a prescription. But Hill was unconvinced. They thought their symptoms were similar to ones their father had. So, they reached out to their estranged parent. In February 2013, their father emailed back and advised them to seek medical care specifically for AS.<\/p>\n<p>Hill was officially diagnosed the next month.<\/p>\n<p>\u201cI think a lot of people have relief when they finally know what&#8217;s going on,\u201d Hill says. But they had the opposite reaction.<\/p>\n<div id=\"em-pullquote-11\" class=\"left\" ref=\"em-pullquote-11\">\n<aside data-e2e=\"ia-pull-quote\" id=\"ia-pull-quote\" align=\"left\" class=\"ia-module-container ia-pull-quote left\">\n<blockquote class=\"pq-wrapper\">\n<p class=\"pq-title\">\n\t\t\t\t\t\t\t\t\t\t\t\t\tDepression and chronic disease are like cousins, they hang out a lot.\n\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t<small class=\"pq-description\"><br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\tCharis Ann Hill<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/small>\n\t\t\t\t\t\t\t\t\t\t\t<\/p><\/blockquote>\n<\/aside><\/div>\n<p>Hill saw their father once a year while growing up, and the memories of how the disease took a toll on his body brought on fear.<\/p>\n<\/section>\n<section>\n<p>\u201cImmediately, I thought that&#8217;s what my life is going to be,\u201d Hill says. \u201cI\u2019m going to become my dad.\u201d<\/p>\n<p>It took time for Hill to come to terms with their lifelong condition. The long and frustrating quest to find a diagnosis was mentally and emotionally exhausting.<\/p>\n<p>\u201c<a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/www.webmd.com\/depression\/default.htm\" data-crosslink-type=\"article\">Depression<\/a> and chronic disease are like cousins, they hang out a lot,\u201d Hill says.<\/p>\n<p>On the flip side, Hill is grateful that their belated diagnosis allowed them to live care-free. It allowed them to have the time to indulge in adventures like bungee jumping, to play college soccer, and even to study abroad.<\/p>\n<p>\u201cI went through 5 years of having what I was going through, and that\u2019s how long it took for me to accept it,\u201d Hill says. \u201cSo don&#8217;t let people pressure you into accepting something before you&#8217;re ready.\u201d<\/p>\n<\/section>\n<\/div>\n<p>[ad_2]<br \/>\n<br \/><a href=\"https:\/\/www.webmd.com\/ankylosing-spondylitis\/features\/ankylosing-spondylitis-diagnosis?src=RSS_PUBLIC\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>[ad_1] \u00a0 Carlos Julio Aponte, MD, still remembers his ankylosing spondylitis (AS) patient No. 1. The man, a former traffic controller, was referred to Aponte more than 4 decades ago,&hellip;<\/p>\n","protected":false},"author":1,"featured_media":1684,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[38],"tags":[],"class_list":["post-1683","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sexting"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Why It Takes So Long to Diagnose Ankylosing Spondylitis - Adult Guest Blog Posting Website for Australia - Adultserviceau.com.au<\/title>\n<meta name=\"description\" content=\"\u00a0Carlos Julio Aponte, MD, still remembers his ankylosing spondylitis (AS) patient No. 1. The man, a former traffic controller, was referred to Aponte more\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/adultserviceau.com.au\/blog\/why-it-takes-so-long-to-diagnose-ankylosing-spondylitis\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Why It Takes So Long to Diagnose Ankylosing Spondylitis - Adult Guest Blog Posting Website for Australia - Adultserviceau.com.au\" \/>\n<meta property=\"og:description\" content=\"\u00a0Carlos Julio Aponte, MD, still remembers his ankylosing spondylitis (AS) patient No. 1. 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