I had to learn to always have a “high level of suspicion” for Ankylosing Spondylitis (AS) while a rheumatologist-in-training. This meant, I needed to “unlearn” most of what I was taught about back pain as an internal medicine resident. As an internist or primary care provider, you see a lot of patients with back pain. It is very common. In order to keep costs down and not overly worry patients, doctors are trained to treat back pain with common anti-inflammatory medications before jumping to x-rays and MRIs. And this isn’t JUST to keep costs down. The overwhelming majority of those with back pain will have resolution of that pain within 2 months. Hence, doing an MRI on every patient just doesn’t make sense. But as a rheumatologist, we are trained to look at back pain differently.
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