Courtney, I also had fairly low inflammation markers and HLAB-27+. Are you taking any medications/supplements? I was taking Apriso for ulcerative colitis so I believe that lowered my levels. Also, I take Krill Oil and Turmeric. What about NSAIDs or steroids? If you are taking those it will lower your blood inflammation levels because that is their job. However, once the inflammation has done damage, it could be in a quieter period, but still causing the joint pain. The SI injections are very helpful and if they work after a couple times then you might be able to get the pain management doctor to diagnosis you with sacroiliitis. However, you should have already been diagnosed based on your MRI. One Rheumatologist told me that I had just degenerative arthritis, but the other doctor finally diagnosed me after a year. I mentioned to him the ASAS Criteria for Rheumatologists. We tried Plaquenil unsuccessfully and diagnosis went from inflammatory polyarthropathy w/ fibromyalgia to axial spondylarthritis with fibromyalgia and now treatment with Sulfasalazine. I am noticing a small reduction in pain and it's only been a month on the Sulfasalazine.

I rarely have elevated inflammation markers such as CRP. My ESR is up at times. It doesn’t mean anything. If you’re symptomatic, especially with the HLA-B27, you probably have AS. I used to try to tell me anything to convince myself I didn’t have it. But having 10 years of looking for a diagnosis I was glad to know.

Hi there, I've done so much reading about this disease since seeing the term on MRI in October and I have read that the inflammatory markers can often be normal which is another reason why it often goes undiagnosed for so long. My MRI also says severe facet joint Spondyloarthropy with the worst in the lower lumbar spine as well. I'm still waiting to see a Rheumatologist though because there is such a shortage. And it seems my doctor doesn't know a lot about this disease.

Oh good, I hope it can help you! Your MRI radiology report should be enough, that is what my Rheumatologist had asked for. He didn't even want to see the actual disc of images. I am not certain if taking IBprofen the day of would effect the test, but if that is what you use on a regular basis for pain then I believe it could appear you don't have inflammation, but really there is an underlying rheumatological condition going on. In fact, IB profen is one of the first treatments they recommend to stop the joint damaging inflammation. However, I had to stop the NSAIDs because of bleeding with bowel movements and flaring of my ulcerative colitis with bloating and constipation. Fun stuff.lol Anyhow, maybe this will give you a good arguing point, if the doctor tries to dismiss your concerns.

This is super helpful. I had taken an 800 MG ibuprofen about 1 hour before the appointment and labs. I only had a sacral MRI but not an xray.