The article presents the results of a clinical observation of a case of the onset of axial spondyloarthritis in an elderly woman which developed against the background of the new coronavirus infection. The difficulties of the diagnostic search and, as a consequence, the selection of adequate therapy in combination with the patient’s post-COVID period and the onset of immuno-inflammatory disease are described. The characteristics of the clinical course and functional features of the patient are given. The issues of differential diagnosis between immuno-inflammatory disease, infectious and paraneoplastic processes are considered. Colonoscopy gave new data on the presence of Crohn’s disease in the patient and allowed excluding the oncological process, serving as a reason for further diagnostic search for spondyloarthritis. The revealed laboratory and instrumental changes made it possible to diagnose axial spondyloarthritis in this patient.
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