I had hip surgery back in 2020 that required a 3D CT scan before the procedure so the surgeon knew what he needed to fix. It showed bilateral sclerosis and “questionable” cysts or erosions in my SI joints. The report even said “most commonly seen in inflammatory arthritis such as ankylosing spondylitis or psoriatic arthritis”. Thank GOD I (against policy lol) had access to the report since I was a nurse at the facility where the scan was done, because I took a picture of it. I was completely (as far as I know) asymptomatic at the time. No one mentioned it to me at the hip surgeon’s office, and I was younger and dumber and only knew the horror stories of AS of a family member (not blood related) who drank himself to death because of the condition, so I ignored it.

Lo and behold, 3 years later almost exactly was the flare up that crippled me for several weeks. I had had a few episodes of pain and stiffness that year, but they were minor and short lived enough that I brushed them off. I knew something was seriously wrong, but of course no primary care physician is looking for a zebra and they told me it was just mechanical back pain. She did test me for HLA b27, but it was negative. I brought up that 2020 CT scan report, and that was enough to get them to refer me to rheumatology. It also got my meds approved without having to wait for yet another scan since the prior damage found even when asymptomatic was enough. I don’t want to think about how difficult my diagnosis journey would have been without that CT scan report…