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  • Alternative diagnoses in patients with chronic back pain not diagnosed with axial spondyloarthritis: data from the SPACE cohort

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Correspondence
Alternative diagnoses in patients with chronic back pain not diagnosed with axial spondyloarthritis: data from the SPACE cohort
  1. Zineb Ez-Zaitouni1,
  2. Robert B M Landewé2,
  3. Désirée van der Heijde1,
  4. Floris A van Gaalen1
  1. 1 Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  2. 2 Department of Rheumatology, Amsterdam Rheumatology & Immunology Center (ARC), Amsterdam, The Netherlands
  1. Correspondence to Zineb Ez-Zaitouni, Department of Rheumatology, Leiden University Medical Center, Leiden 2300 RC, The Netherlands; z.ez-zaitouni{at}lumc.nl

https://doi.org/10.1136/annrheumdis-2017-212175

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    We recently published a study investigating whether the mere presence of multiple spondyloarthritis (SpA) features is sufficient for an axial spondyloarthritis (axSpA) diagnosis.1 Patients (n=500) with chronic back pain (CBP) suspected of axSpA were stratified according to their number of SpA features into four subgroups: ≤1, 2, 3 and ≥4 SpA features based on medical history taking, physical examination and measurement of acute phase reactants, but before sacroiliac imaging and HLA-B27 testing. In total, 24% (38/159), 43% (62/143), 62% (49/79) and 85% (101/119) of CBP patients with ≤1, 2, 3 and ≥4 SpA features, respectively, were diagnosed with axSpA. In particular, HLA-B27 positivity and imaging findings highly suggestive of axSpA were strongly associated with an axSpA diagnosis. Although …

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    Footnotes

    • Contributors All authors contributed to the study design and interpretation of data. ZEZ was responsible for the statistical analysis and prepared the first version of the manuscript. All authors approved the final version of the manuscript.

    • Competing interests None declared.

    • Ethics approval This study has been approved by the local medical ethics committees. All patients provided written informed consent.

    • Provenance and peer review Not commissioned; internally peer reviewed.