Fast Five Quiz: Nonradiographic Axial Spondyloarthritis Management

Abhishek Nandan, MD;  Evan Dombrosky, MD

Disclosures

March 28, 2024

Nonradiographic axial spondyloarthritis (nr-axSpA) is a form of axial spondyloarthritis (axSpA) which is distinct from radiographic axSpA (r-axSpA), also known as ankylosing spondylitis (AS). Patients with nr-axSpA present with predominantly axial features, and sometimes additional clinical features of AS (eg, inflammatory back pain and enthesitis or arthritis) but with normal radiographs of the sacroiliac joints and spine. The American College of Rheumatology (ACR), Spondylitis Association of America, and the Spondyloarthritis Research and Treatment Network have explained, "Although nonradiographic axial SpA shares several features with AS, advanced sacroiliac joint damage and spine ankylosis are absent." While AS is more prevalent in males than in females, nr-axSpA is seen roughly equally in both.

Diagnosing nr-axSpA can be challenging, as patients often present with symptoms common to other conditions; with the absence of radiographic changes needed to diagnose AS (although changes might be evident in peripheral or axial joints), it can be hard to pinpoint. However, pattern recognition can offer diagnostic clues (eg, signs or symptoms of inflammatory back pain, use and response to nonsteroidal anti-inflammatory drugs (NSAIDs), and family history of spondyloarthritis of any kind).

Although outcomes are generally good, early detection of nr-axSpA is important to help preserve joint function and mobility because this group of patients can still benefit from classic AS/r-axSpA treatment options.

How much do you know about the management of nr-axSpA? Test your knowledge with this quick quiz.

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