Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Spondyloarthropathies

Identifying axial SpA in young adults with chronic back pain

Nature Reviews Rheumatology volume 12, pages 378–380 (2016)Cite this article

Subjects

Diagnostic algorithms for axial spondyloarthritis (SpA), and classification criteria for use in clinical trials, are being developed and refined. But can axial SpA be ruled out in young patients with only one clinical feature of SpA prior to imaging studies and HLA-B27 testing?

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Diagnostic algorithms for axial spondyloarthritis (SpA) in patients with chronic back pain.

References

  1. Sieper, J. & Rudwaleit, M. Early referral recommendations for ankylosing spondylitis (including pre-radiographic and radiographic forms) in primary care. Ann. Rheum. Dis. 64, 659–663 (2005).

    Article  CAS  Google Scholar 

  2. Rudwaleit, M. & Sieper, J. Referral strategies for early diagnosis of axial spondyloarthritis. Nat. Rev. Rheumatol. 8, 262–268 (2012).

    Article  CAS  Google Scholar 

  3. Bakker, P. A. et al. Patients aged 16–45 years with chronic back pain of a short duration and maximally 1 SpA-feature: Are additional tests needed to rule out axial spondyloarthritis? (results from the SPACE cohort). Arthritis Care Res. (Hoboken) http://dx.doi.org/10.1002/acr.22883 (2016).

  4. van den Berg, R. et al. Percentage of patients with spondyloarthritis in patients referred because of chronic back pain and performance of classification criteria: experience from the Spondyloarthritis Caught Early (SPACE) cohort. Rheumatology 52, 1492–1499 (2013).

    Article  Google Scholar 

  5. Rudwaleit, M. et al. The development of Assessment of SpondyloArthritis International Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann. Rheum. Dis. 68, 777–783 (2009).

    Article  CAS  Google Scholar 

  6. van den Berg, R. et al. ASAS modification of the Berlin algorithm for diagnosing axial spondyloarthritis: results from the SPondyloArthritis Caught Early (SPACE)-cohort and from the Assessment of SpondyloArthritis international Society (ASAS) cohort. Ann. Rheum. Dis. 72, 1646–1653 (2013).

    Article  Google Scholar 

  7. Rudwaleit, M., van der Heijde, D., Khan, M. A., Braun, J. & Sieper, J. How to diagnose axial spondyloarthritis early. Ann. Rheum. Dis. 63, 535–543 (2004).

    Article  CAS  Google Scholar 

  8. Mandl, P. et al. EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice. Ann. Rheum. Dis. 74, 1327–1339 (2015).

    Article  CAS  Google Scholar 

  9. Rudwaleit, M. et al. Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group. Ann. Rheum. Dis. 68, 1520–1527 (2009).

    Article  CAS  Google Scholar 

  10. Lambert, R. G. et al. Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group. Ann. Rheum. Dis. http://dx.doi.org/10.1136/annrheumdis-2015-208642 (2016).

Download references

Acknowledgements

M.R.'s research has been funded in part by the Deutsche Forschungsgemeinschaft (DFG), grant FKZ RU 68/5-1.

Author information

Authors and Affiliations

  1. Department of Internal Medicine and Rheumatology, Klinikum Bielefeld Rosenhöhe, Klinik f. Innere Medizin und Rheumatologie, An der Rosenhöhe 27, 33647 Bielefeld, Germany; the Charité University Medicine, Med. Klinik 1, Hindenburgdamm 30, 12203 Berlin, Germany; and at Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.,

    Martin Rudwaleit

  2. the Charité University Medicine, Med. Klinik 1, Hindenburgdamm 30, 12203 Berlin, Germany,

    Martin Rudwaleit

Authors
  1. Martin Rudwaleit
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin Rudwaleit.

Ethics declarations

Competing interests

The author declares that he has received consultancy fees and/or speakers' honoraria from Abbvie, Bristol–Myers–Squibb, Chugai, Janssen–Cilag, Merck, Sharp & Dohme, Novartis, Pfizer, Roche and UCB.

PowerPoint slides

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rudwaleit, M. Identifying axial SpA in young adults with chronic back pain. Nat Rev Rheumatol 12, 378–380 (2016). https://doi.org/10.1038/nrrheum.2016.98

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrrheum.2016.98

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing