Highlights & Basics
- Axial spondyloarthritis is classified as spondyloarthropathy. The spondyloarthropathies (including psoriatic arthritis, enteropathic arthritis, and reactive arthritis) are a heterogenous group of conditions with overlapping clinical manifestations and association with the gene HLA-B27.
- Axial spondyloarthritis is a chronic progressive inflammatory arthropathy, which can ultimately lead to radiographic changes in the spine and sacroiliac joints. This radiographic stage is known as ankylosing spondylitis (AS).
- Inflammatory back pain is the hallmark clinical feature. This is back pain that is of insidious onset, is worse in the morning, and improves with exercise.
- A positive response to nonsteroidal anti-inflammatory drugs (NSAIDs) is characteristic of most patients.
- Physical therapy and NSAIDs are the cornerstone of treatment. In people whose symptoms are refractory to these approaches, tumor necrosis factor-alpha inhibitors and interleukin-17 inhibitors play a key role.
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History & Exam
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Citations
Ramiro S, Nikiphorou E, Sepriano A, et al. ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Ann Rheum Dis. 2023 Jan;82(1):19-34.[Abstract][Full Text]
Ward MM, Deodhar A, Gensler LS, et al. 2019 update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network recommendations for the treatment of ankylosing spondylitis andnonradiographic axial spondyloarthritis. Arthritis Rheumatol. 2019 Oct;71(10):1599-613.[Abstract][Full Text]
National Institute for Health and Care Excellence (UK). Spondyloarthritis in over 16s: diagnosis and management. Jun 2017 [internet publication].[Full Text]
- BMJ: identifying and referring spondyloarthritis (infographic)
- Bath Ankylosing Spondylitis Metrology Index (BASMI)
- Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)
- Bath Ankylosing Spondylitis Functional Index (BASFI)
- Versus Arthritis: ankylosing spondylitis
- Spondylitis Association of America
- National Axial Spondyloarthritis Society
- Axial Spondyloarthritis International Federation
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