Possible building blocks for the diagnosis of axSpA (based on the ASAS classification criteria)—part 1: early diagnosis
Nr
Feature
Description/Definition
Decision
1
Back pain 1
Chronic ≥ 3 months in people < 45 years of age
Present yes/no
2
Back pain 2
Inflammatory = morning stiffness > 30 minutes, improvement with exercise, no improvement with rest, nocturnal awakening in the 2nd half of the night, insidious onset
At least 3 of those, better 4.Present yes/no
3
Imaging
MRI, X-ray, computed tomography of the sacroiliac joints and/or the spine
Positive findings regarding inflammation and/or structural changesPast or present yes/no
Good response to non-steroidal anti-inflammatory drugs (NSAIDs)
Past or present yes/no
10
Exclusion
Other important reasons for the presenting symptoms (see text: explanations of the individual building blocks for the diagnosis of axSpA)
Absence yes/no
axSpA: axial spondyloarthritis; ASAS: Assessment of SpondyloArthritis International Society; SpA: spondyloarthritides; Nr: number; MRI: magnetic resonance imaging. For more explanation see the text: explanations of the individual building blocks for the diagnosis of axSpA
Declarations
Author contributions
JB: Conceptualization, Investigation, Writing—original draft. DP: Writing—review & editing, Investigation, Validation. All authors read and approved the submitted version.
Conflicts of interest
Jürgen Braun, who is the Associate Editor of Exploration of Musculoskeletal Diseases, had no involvement in the decision-making or the review process of this manuscript. The other authors declare that they have no conflicts of interest.
Ethical approval
According to the local guidelines, since this is a review and not a study, no ethical approval is needed in Germany.
Consent to participate
All patients in the University Hospital B. Franklin in Berlin give informed consent.
Consent to publication
All patients in the University Hospital B. Franklin in Berlin give informed consent.
Availability of data and materials
The raw data supporting the conclusions of this manuscript can be requested from the corresponding author for appropriate reasons.
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