Identifying patients with axial spondyloarthritis in primary care: how useful are items indicative of inflammatory back pain?

Annals of the Rheumatic Diseases
A BraunJürgen Braun

Abstract

The value of clinical items defining inflammatory back pain to identify patients with axial spondyloarthritis (SpA) in primary care is unclear. To identify predictive clinical parameters for a diagnosis of axial SpA in patients with chronic back pain presenting in primary care. Consecutive patients aged < 45 years (n=950) with back pain for > 2 months who presented to orthopaedic surgeons (n=143) were randomised based on four key questions for referral to rheumatologists (n=36) for diagnosis. The rheumatologists saw 322 representative patients (mean age 36 years, 50% female, median duration of back pain 30 months). 113 patients (35%) were diagnosed as axial SpA (62% HLA B27+), 47 (15%) as ankylosing spondylitis (AS) and 66 (21%) as axial non-radiographic SpA (nrSpA). Age at onset ≤ 35 years, improvement by exercise, improvement with non-steroidal anti-inflammatory drugs, waking up in the second half of the night and alternating buttock pain were identified as most relevant for diagnosing axial SpA by multiple regression analysis. Differences between AS and nrSpA were detected. No single item was predictive, but ≥ 3 items proved useful for good sensitivity and specificity by receiver operating characteristic modelling. This stud...Continue Reading

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Citations

Jan 31, 2012·Zeitschrift für Rheumatologie·D PoddubnyyJ Sieper
Jan 31, 2012·Zeitschrift für Rheumatologie·X Baraliakos, J Braun
Mar 28, 2012·Nature Reviews. Rheumatology·Astrid van Tubergen, Ulrich Weber
Apr 11, 2012·Nature Reviews. Rheumatology·Martin Rudwaleit, Joachim Sieper
Jul 28, 2012·The Journal of Orthopaedic and Sports Physical Therapy·Chelsea L Jordan, Daniel I Rhon
Jun 10, 2014·Iranian Red Crescent Medical Journal·Mehrzad HajialiloNadereh Rashtchizadeh
Jul 10, 2012·Current Rheumatology Reports·Salih Ozgocmen, Muhammad Asim Khan
Oct 30, 2012·Reumatología clinica·Ruth López-GonzálezUNKNOWN Grupo Esperanza
Oct 23, 2012·Rheumatic Diseases Clinics of North America·Michael H Weisman
Oct 23, 2012·Rheumatic Diseases Clinics of North America·Denis Poddubnyy, Désirée van der Heijde
Oct 23, 2012·Rheumatic Diseases Clinics of North America·Jürgen Braun, Joachim Sieper
Oct 23, 2012·Rheumatic Diseases Clinics of North America·Rubén Burgos-Vargas, Jürgen Braun
Oct 23, 2012·Rheumatic Diseases Clinics of North America·Jürgen Braun, Joachim Sieper
Jul 24, 2012·Rheumatic Diseases Clinics of North America·Denis Poddubnyy, Martin Rudwaleit
Jan 24, 2012·Best Practice & Research. Clinical Rheumatology·Xenofon Baraliakos, Juergen Braun
Mar 17, 2016·Scandinavian Journal of Rheumatology·B ArnbakC Manniche
Dec 13, 2012·Arthritis and Rheumatism·Joachim Sieper, Désirée van der Heijde
May 21, 2015·Annals of the Rheumatic Diseases·Denis PoddubnyyUNKNOWN Assessment of SpondyloArthritis international Society (ASAS)
Dec 4, 2014·Arthritis Care & Research·Nicole ThomMichael H Weisman
Jun 23, 2015·Best Practice & Research. Clinical Rheumatology·J BraunU Kiltz
May 8, 2015·Clinical Rheumatology·Abhijeet Danve, Atul Deodhar
Dec 24, 2014·Seminars in Arthritis and Rheumatism·Annelies BoonenSameer Kotak
Mar 26, 2015·Zeitschrift für Rheumatologie·J Sieper, J Braun
Sep 23, 2014·Reumatología clinica·Xavier Juanola RouraUNKNOWN Grupo de estudio para el Dolor Lumbar Inflamatorio
Jan 13, 2015·The Journal of Orthopaedic and Sports Physical Therapy·Robin HaskinsDarren A Rivett
Jan 27, 2017·Zeitschrift für Rheumatologie·X BaraliakosJ Braun
Jan 27, 2016·The Journal of International Medical Research·Mohammed HammoudehUppal Sukhbir
Oct 14, 2017·Rheumatology·Chong Seng Edwin LimKarl Gaffney
May 4, 2017·Annals of the Rheumatic Diseases·David S Pisetsky
Nov 17, 2014·The Journal of Rheumatology·Jurgen BraunJoachim Sieper
Dec 28, 2018·Clinical Rheumatology·Abhijeet Danve, Atul Deodhar

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