Spondyloarthritis (SpA) is a spectrum of chronic inflammatory diseases of which ankylosing spondylitis (AS) is the best known pendant. SpA is often characterized by inflammatory low back pain (nightpain, morning stiffness, improvement with exercise), and called axial SpA. But patients with SpA can also present with arthritis, enthesitis and/or dactylitis (peripheral SpA).
A diagnosis of AS requires radiographic sacro-iliitis, which is often a late feature. Patients may have complaints years before radiographic abnormailities appear, and in some patients these abnormailities will never appear, whilst these patients may suffer from similar levels of pain, stiffness and functional impairment as patients with a classifying diagnosis of AS.
In order to fill this diagnostic gap, the Assessment in Spondyloarthritis International Society (ASAS) has recently developed new classification criteria for axial and peripheral SpA, that may help in an earlier detection of patients with SpA, and can serve as eligibility criteria for randomised clinical trials.
In order to get the appropriate patients early enough at the appropriate place (the rheumatologist) primary care workers should have knowledge about early signs of SpA, and should have the tools to decide about early referral in the patients that need this.
Disclosure of Interest None Declared
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