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Referral strategies for early diagnosis of axial spondyloarthritis

Publication at First Faculty of Medicine |
2014

Abstract

Axial spondyloarthritis is an umbrella term for both ankylosing spondylitis and non-radiographic axial spondyloarthritis, characteristic by no signs of damage to the sacroiliac joint are visible on x-ray. This disease usually manifests by chronic back pain, starting before 45 years of age.

Diagnosis and treatment of axial spondyloarthritis belongs in the hands of a specialist - a rheumatologist. Therefore it is necessary to create a simple reference strategy that would enable physicians in primary care to efficiently identify and refer patients in whom there is a suspicion of having this disease to the specialists.

Based on published data the most appropriate strategy seems to be using a combination of the presence of inflammatory back pain, HLA-B27 positivity and evidence of sacroiliitis on imaging studies as the evidence necessary to warrant referring a patient to a specialist.