Related Experiment Video
Updated: Jan 4, 2026

Synovial Fluid Analysis to Identify Osteoarthritis
Published on: October 20, 2022
Positive HLA-B27 and sacroiliitis is not always spondyloarthritis
Fawad Aslam1, Frederick Spencer Chivers2, Krupa B Doshi3
1Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA.
Abstract:
A 36-year-old man was treated for several years with multiple agents for ankylosing spondylitis based on positive human leukocyte antigen-B27 and sacroiliitis. He was also diagnosed with osteoporosis and hypophosphatemia. Over these years, from being an avid runner, he became dependent on a walker for ambulation. The lack of treatment response and the low phosphorus were clues that eventually led to a diagnosis of tumor-induced osteomalacia. This case discusses the importance of not solely relying on genetic markers and sacroiliitis for diagnosing ankylosing spondylitis as other conditions can cause similar presentations.
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