Non-radiographic axial spondyloarthritis
Axial spondyloarthritis without definite radiographic signs of sacroiliitis. Diagnosis is based on a combination of clinical findings.
About the condition
Axial spondyloarthritis without definite radiographic signs of sacroiliitis. Diagnosis is based on a combination of clinical findings.
Includes radiographic and non-radiographic forms. A normal plain X-ray does not mean inflammatory disease is absent.
Symptoms
Inflammatory back pain, night pain, stiffness and enthesitis may occur. A normal radiograph does not mean the condition is absent.
Pain usually begins in younger adulthood, lasts months and accompanies stiffness. Enthesitis, uveitis, psoriasis or IBD help identify the pattern.
Diagnosis
A rheumatologist assesses clinical features, sacroiliac MRI and blood tests. HLA-B27 or an isolated MRI finding is insufficient for diagnosis.
Sacroiliac MRI is used when clinically indicated. Some MRI findings are nonspecific and must be interpreted with symptoms.
Treatment
Movement, rehabilitation and clinician-selected therapy are central. Targeted treatment decisions consider activity, objective inflammation and other conditions.
Education and regular therapeutic exercise are central. NSAIDs require risk assessment; conventional DMARD tablets generally do not control isolated axial inflammation.
Monitoring
Symptoms, ASDAS, function and treatment safety are monitored. Report new eye, bowel or skin manifestations to your clinician.
Follow activity, function, sleep and exercise tolerance. New bowel or eye symptoms may change treatment selection.
Sources
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