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Published online: 2024-03-22

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Delayed diagnosis of axial spondyloarthritis

Katarzyna Wiąk-Walerowicz1, Ewa Wielosz1


Axial spondyloarthritis (axSpA) is an inflammatory joint disease whose predominant symptom is inflammatory pain in the spine. It occurs in approximately 1% of the population, with a higher incidence in men. Spinal pain in the course of spondyloarthritis is called inflammatory back pain. In addition to inflammatory back pain, other symptoms of axSpA include enthesitis, peripheral arthritis and extra-articular symptoms. A patient's family history and human leukocyte antigen B27 (HLA-B27) should also be considered, as these correlate closely with a higher incidence of spondyloarthritis. AxSpA is often underdiagnosed, and no specific serological test or physical examination can determine the diagnosis of spondyloarthritis. Despite good knowledge of the disease, the time between the first symptoms and diagnosis is still too long, which adversely affects the subsequent treatment options, as well as the mental and economic condition of patients. Patients are not referred to a rheumatologist quickly enough. Therefore, the features of inflammatory back pain, the symptoms associated with axial spondyloarthritis and the diagnostic tests should be well known by general practitioners and other specialists to whom patients with pain are first referred. This would accelerate accurate diagnosis and prompt implementation of appropriate treatment. This paper discusses symptoms of axSpA and emphasises the importance of prompt diagnosis in patients with complaints typical of spondyloarthritis.


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