REVIEW

Early referral recommendations for ankylosing spondylitis (including pre-radiographic and radiographic forms) in primary care

J Sieper, M Rudwaleit

Medical Department I, Rheumatology, Campus Benjamin Franklin Charitè, University Medicine Berlin, Germany

Correspondence to:
Medical Department I
Rheumatology, Charitè, University Medicine Berlin, Germany, Hindenburgdamm 30, 12200 Berlin, Germany; joachim.sieper{at}charite.de

An earlier diagnosis of ankylosing spondylitis (AS) is required because there is still a 5–7 year delay between first symptoms and diagnosis, and new effective treatments are available for active disease. Primary care physicians need easy to apply parameters to help them identify patients with suspected AS for onward referral. The best measures found were inflammatory back pain and HLA-B27 positivity.

Abbreviations: AS, ankylosing spondylitis; CRP, C reactive protein; ESR, erythrocyte sedimentation rate; IBP, inflammatory back pain; LR, likelihood ratio; MRI, magnetic resonance imaging; NSAIDs, non-steroidal anti-inflammatory drugs

Keywords: ankylosing spondylitis; screening; primary care

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Jois, R. N., Macgregor, A. J., Gaffney, K. (2008). Recognition of inflammatory back pain and ankylosing spondylitis in primary care. Rheumatology (Oxford) 47: 1364-1366 [Abstract] [Full Text]  
• Sidiropoulos, P. I., Hatemi, G., Song, I.-H., Avouac, J., Collantes, E., Hamuryudan, V., Herold, M., Kvien, T. K., Mielants, H., Mendoza, J. M., Olivieri, I., Ostergaard, M., Schachna, L., Sieper, J., Boumpas, D. T., Dougados, M. (2008). Evidence-based recommendations for the management of ankylosing spondylitis: systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising rheumatologists. Rheumatology (Oxford) 47: 355-361 [Abstract] [Full Text]  
• Brandt, H. C., Spiller, I., Song, I.-H., Vahldiek, J. L, Rudwaleit, M., Sieper, J. (2007). Performance of referral recommendations in patients with chronic back pain and suspected axial spondyloarthritis. Ann Rheum Dis 66: 1479-1484 [Abstract] [Full Text]  
• Collantes, E., Zarco, P., Munoz, E., Juanola, X., Mulero, J., Fernandez-Sueiro, J. L., Torre-Alonso, J. C., Gratacos, J., Gonzalez, C., Batlle, E., Fernandez, P., Linares, L. F., Brito, E., Carmona, L. (2007). Disease pattern of spondyloarthropathies in Spain: description of the first national registry (REGISPONSER) extended report. Rheumatology (Oxford) 46: 1309-1315 [Abstract] [Full Text]  
• Smellie, W S A, Forth, J, Coleman, J J, Irvine, W, Dore, P C, Handley, G, Williams, D G, Galloway, P J, Kerr, K G, Herriot, R, Spickett, G P, Reynolds, T M (2007). Best practice in primary care pathology: review 6. J. Clin. Pathol. 60: 225-234 [Abstract] [Full Text]  
• Zochling, J., Brandt, J., Braun, J. (2005). The current concept of spondyloarthritis with special emphasis on undifferentiated spondyloarthritis. Rheumatology (Oxford) 44: 1483-1491 [Full Text]  
• Sieper, J, Rudwaleit, M (2005). How early should ankylosing spondylitis be treated with tumour necrosis factor blockers?. Ann Rheum Dis 64: iv61-iv64 [Abstract] [Full Text]