Challenges in the diagnosis of axial spondyloarthritis

IF 4.5 2区医学 Q1 RHEUMATOLOGY

Best Practice & Research in Clinical Rheumatology Pub Date : 2023-09-01 DOI:10.1016/j.berh.2023.101871

Floris A. van Gaalen , Martin Rudwaleit

引用次数: 0

Abstract

With back pain as one of the most common complaints in the population and with no single disease feature with sufficient sensitivity and specificity to diagnose axial spondyloarthritis (axSpA) on its own, diagnosing axSpA can be challenging. In this article, we discuss clinical, laboratory, and imaging spondyloarthritis features that can be used in diagnosis and explain the general principles underlying an axSpA diagnosis. Moreover, we discuss three pitfalls to avoid when diagnosing axSpA: i) using classification criteria as diagnostic criteria, ii) making a diagnosis by simple counting of spondyloarthritis features, and iii) over-reliance on imaging findings. Finally, we have some advice on how to build diagnostic skills and discuss new developments that may help facilitate the diagnosis of axSpA in the future.

查看原文本刊更多论文

轴性脊柱关节炎的诊断难题

背痛是人群中最常见的主诉之一，没有一种疾病特征具有足够的敏感性和特异性来单独诊断轴突性脊柱关节炎（axSpA），因此诊断 axSpA 具有挑战性。在本文中，我们讨论了可用于诊断的临床、实验室和影像学脊柱关节炎特征，并解释了诊断 axSpA 的一般原则。此外，我们还讨论了诊断 axSpA 时应避免的三个误区：i) 将分类标准作为诊断标准；ii) 通过简单计算脊柱关节炎特征来做出诊断；iii) 过度依赖影像学检查结果。最后，我们就如何提高诊断技能提出了一些建议，并讨论了未来可能有助于促进 axSpA 诊断的新进展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Best Practice & Research in Clinical Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

0.00%

发文量

审稿时长

27 days

期刊介绍： Evidence-based updates of best clinical practice across the spectrum of musculoskeletal conditions. Best Practice & Research: Clinical Rheumatology keeps the clinician or trainee informed of the latest developments and current recommended practice in the rapidly advancing fields of musculoskeletal conditions and science. The series provides a continuous update of current clinical practice. It is a topical serial publication that covers the spectrum of musculoskeletal conditions in a 4-year cycle. Each topic-based issue contains around 200 pages of practical, evidence-based review articles, which integrate the results from the latest original research with current clinical practice and thinking to provide a continuous update. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. The review articles seek to address the clinical issues of diagnosis, treatment and patient management. Management is described in practical terms so that it can be applied to the individual patient. The serial is aimed at the physician in both practice and training.