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Spondyloarthropathies

How should axial spondyloarthritis be diagnosed?

Nature Reviews Rheumatology volume 13, pages 264–266 (2017)Cite this article

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Results from a cohort study are challenging the diagnostic algorithm proposed by the Assessment of Spondyloarthritis International Society by showing that rheumatologists are not always confirming a diagnosis of axial spondyloarthritis in patients with multiple features of spondyloarthritis. How will these results affect the future development of classification criteria?

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References

  1. Rudwaleit, M. et al. The early disease stage in axial spondylarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis Rheum. 60, 717–727 (2009).

    Article  CAS  Google Scholar 

  2. 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 

  3. Chung, H. Y., Machado, P., van der Heijde, D., D'Agostino, M. A. & Dougados, M. HLA-B27 positive patients differ from HLA-B27 negative patients in clinical presentation and imaging: results from the DESIR cohort of patients with recent onset axial spondyloarthritis. Ann. Rheum. Dis. 70, 1930–1936 (2011).

    Article  Google Scholar 

  4. 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 

  5. Braun, J., Baraliakos, X., Kiltz, U., Heldmann, F. & Sieper, J. Classification and diagnosis of axial spondyloarthritis — what is the clinically relevant difference? J. Rheumatol. 42, 31–38 (2015).

    Article  Google Scholar 

  6. Deodhar, A., Strand, V., Kay, J. & Braun, J. The term 'non-radiographic axial spondyloarthritis' is much more important to classify than to diagnose patients with axial spondyloarthritis. Ann. Rheum. Dis. 75, 791–794 (2016).

    Article  CAS  Google Scholar 

  7. Ez-Zaitouni, Z. et al. Presence of multiple spondyloarthritis (SpA) features is important but not sufficient for a diagnosis of axial spondyloarthritis: data from the SPondyloArthritis Caught Early (SPACE) cohort. Ann. Rheum. Dis. http://dx.doi.org/10.1136/annrheumdis-2016-210119, (2017).

  8. Aletaha, D. et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann. Rheum. Dis. 69, 1580–1588 (2010).

    Article  Google Scholar 

  9. de Bruin, F. et al. Prevalence of degenerative changes of the spine on magnetic resonance images and radiographs in patients aged 16–45 years with chronic back pain of short duration in the Spondyloarthritis Caught Early (SPACE) cohort. Rheumatology (Oxford) 55, 56–65 (2016).

    Article  Google Scholar 

  10. Braun, J. & Sieper, J. Ankylosing spondylitis. Lancet 369, 1379–1390 (2007).

    Article  Google Scholar 

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Acknowledgements

The authors thank X. Baraliakos for his contributions to discussions of the content of this commentary.

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  1. Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Claudiusstrasse 45, Bochum, 44797, Germany

    Jürgen Braun & Uta Kiltz

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  1. Jürgen Braun
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  2. Uta Kiltz
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Correspondence to Jürgen Braun.

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Braun, J., Kiltz, U. How should axial spondyloarthritis be diagnosed?. Nat Rev Rheumatol 13, 264–266 (2017). https://doi.org/10.1038/nrrheum.2017.38

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