How to investigate: Early axial spondyloarthritis

Publication date: Available online 31 July 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Pedro D. Carvalho, Pedro M. MachadoAbstractAxial spondyloarthritis (axSpA) is a chronic inflammatory condition of the axial skeleton that encompasses radiographic and non-radiographic axSpA and that can lead to chronic pain, structural damage, disability, and loss of quality of life. Scientific advances, including the role of MRI assessment, have led to new diagnostic insights and the creation of a new set of classification criteria for axial and peripheral SpA. New criteria allow the identification of SpA patients with early disease and their enrolment in clinical studies. In this chapter, we discuss the difference between diagnostic and classification criteria, the diagnostic approach to patients with suspected axSpA, the limitations of MRI assessment, and the importance of early identification of this condition. A practical algorithm to investigate axSpA, based on the current evidence, is also proposed. Clinical judgement should always be kept as the mainstay in the diagnosis of axSpA.
Source: Best Practice and Research Clinical Rheumatology - Category: Rheumatology Source Type: research