Fast Five Quiz: Nonradiographic Axial Spondyloarthritis Management

Abhishek Nandan, MD


August 01, 2023

Nonradiographic axial spondyloarthritis (nr-axSpA) is a form of ankylosing spondylitis (AS) in which patients present with predominantly axial features, and sometimes 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 explain, "Although nonradiographic axial SpA shares several features with AS, advanced sacroiliac joint damage and spine ankylosis are absent." Nr-axSpA has a higher predominance in women than in men.

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 may 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. AS is a chronic, progressive disease with significant morbidity, if left untreated.

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


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