Journal
BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY
Volume 33, Issue 4, Pages -Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.berh.2019.07.001
Keywords
Axial spondyloarthritis; Diagnosis; Classification; MRI; Radiographic progression
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Funding
- National Institute for Health Research University College London Hospitals NHS Foundation Trust Biomedical Research Centre
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Axial 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. (C) 2019 Elsevier Ltd. All rights reserved.
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