The frequency of non-radiographic axial spondyloarthritis in relation to symptom duration in patients referred because of chronic back pain: results from the Berlin early spondyloarthritis clinic

Abstract

Non-radiographic axial SpA represents an important differential diagnosis of back pain, especially in patients with recent symptom onset.

Clinical presentation of patients suffering from recent onset chronic inflammatory back pain suggestive of spondyloarthritis: The DESIR cohort

“…There is still a debate whether the absence of structural damage is a pre-stage of the disease (e.g. all the patients will present such structural damage since the % of patients with such structural damage of sacroiliac joint is decreasing overtime [25,26] or a specific characteristic of some patients who will never present structural damage of the sacroiliac joints. This is the reason why such patients are not designated as pre-radiographic axial SpA but as non-radiographic axial SpA [3].…”

Biomarkers, imaging and disease activity indices in patients with early axial spondyloarthritis: the Italian arm of the SpondyloArthritis-Caught-Early (SPACE) Study

“…Several investigators have begun to examine serum and plasma biomarkers to assess their association with disease activity (DA) (16,17), since erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), commonly considered acute-phase proteins reflecting systemic inflammation, often prove to be unrelated to inflammation in axSpA (18)(19)(20). Higher CRP levels in patients with r-axSpA with respect to their nr-axSpA peers (21,22) have been described. Although CRP is not elevated in a large percentage of patients with active axSpA, it is widely considered a reliable parameter of DA and is correlated with the Ankylosing Spondylitis disease activity score (ASDAS) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).…”

Radiographic Evaluation of Sacroiliac Joints in Axial Spondyloarthritis — Still Worth Performing?

“…Similarly, in the ASAS modification of the Berlin diagnostic algorithm for axSpA, radiography of SI joints is again the first imaging method to be applied in case of suspicion of axSpA 6 . Indeed, the method is quick, cheap, and widely available, and up to 50% of the patients with axSpA (even with a relatively short symptom duration of up to 5 yrs) might have definite structural changes in the SI joints visible on radiographs 7 , which means immediate diagnosis and usually no need for an MRI.…”