Clinical Rheumatology

, Volume 35, Issue 10, pp 2627–2628 | Cite as

Poor awareness of inflammatory back pain and axial spondyloarthritis among secondary care specialists

  • Hannah R. Mathieson
  • Mira Merashli
  • Karl Gaffney
  • Helena Marzo-OrtegaEmail author
  • On behalf of BRITSpA (British Society for Spondyloarthritis)
Letter to the Editor


The delay to diagnosis in axial spondyloarthritis (axSpA) in the UK remains long averaging 7 to 8 years. [ 1] This is unacceptable since time may translate into poorer outcomes including pain, functional decline and work disability in young adults. Although reasons for this delay are multifactorial, recent studies have identified lack of GP knowledge as central [ 2]. Diagnostic difficulties are amplified by the fact that chronic back pain is common with only 5 % of these patients likely to have axSpA [ 3]. Furthermore, inflammatory back pain (IBP), the hallmark of axSpA, can be difficult to identify with different criteria describing up to eight characteristic features (Fig.  1). Many subjects with axSpA have extra-articular (EA) features including psoriasis, inflammatory bowel disease (IBD) and acute anterior uveitis (AAU) which may represent a unique diagnostic opportunity as patients may already be attending other secondary care specialists. Anecdotal evidence however suggests...


Inflammatory Bowel Disease Psoriasis Secondary Care Inflammatory Back Pain Acute Anterior Uveitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance with ethical standards


HRM: none; MM: none; KG has received research funding and speaker fees/honoraria from AbbVie, UCB, Pfizer and MSD; HMO has received research funding from Janssen and Pfizer and speaker fees/honoraria from Abbvie, Celgene, Novartis, Pfizer and UCB.


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Copyright information

© International League of Associations for Rheumatology (ILAR) 2016

Authors and Affiliations

  • Hannah R. Mathieson
    • 1
    • 2
  • Mira Merashli
    • 1
    • 2
  • Karl Gaffney
    • 3
  • Helena Marzo-Ortega
    • 1
    • 2
    Email author
  • On behalf of BRITSpA (British Society for Spondyloarthritis)
  1. 1.NIHR Leeds Musculoskeletal Biomedical Research UnitLeeds Teaching Hospitals NHS TrustLeedsUK
  2. 2.Leeds Institute for Rheumatic and Musculoskeletal DiseaseUniversity of LeedsLeedsUK
  3. 3.Department of RheumatologyNorfolk and Norwich University HospitalNorwichUK

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