Spondyloarthritis (SpA)*
may be difficult to diagnose

*Specifically, psoriatic arthritis (PsA) and ankylosing spondylitis (AS).

Quote from SpA HCP, Martindale

  • Key Facts:

  • Psoriatic arthritis (PsA) may progress undiagnosed for approximately 10 years from psoriasis onset, and may even precede it.2

  • In ankylosing spondylitis (AS), diagnostic delays of 8 years and longer have been reported.3

Quote from SpA HCP, Martindale
1 Out of 3 PsA Patients Remain Undiagnosed 1 Out of 3 PsA Patients Remain Undiagnosed

Many patients with psoriatic arthritis (PsA) remain undiagnosed

Nearly one-third (29%) of patients with psoriasis had undiagnosed PsA in a dermatology clinic study.4

More than 50% of Patients Have Delayed Diagnosis

Radiographic diagnosis of AS may be delayed in more than half of patients for 5 years.5

Patients May Suffer Years of Pain from Diagnostic Delays Patients May Suffer Years of Pain from Diagnostic Delays

Ankylosing spondylitis (AS) is largely undiagnosed

Diagnostic delays of 8 years and longer have been reported.3

Possible associated features with confirmed sacroiliitis for axial SpA6

Chronic inflammatory lower back pain plus:

  • HLA-B27
  • Enthesitis (heel)
  • Dactylitis
  • Uveitis
  • Arthritis
  • Crohn's disease/ulcerative colitis
  • Elevated CRP
  • Good response to NSAIDs
  • Family history of SpA
Key Nonradiologic Clues for AS

Recent tools aid earlier diagnosis

  • MRI: EULAR 2015 announced imaging guidelines for earlier detection of SpA7
  • Ankylosing Spondylitis Disease Activity Score Calculator available from ASAS8
Quote from SpA HCP, Mandl Quote from SpA HCP, Mandl
Review SpA Goals Right Arrow Image

ASAS=Assessment of SpondyloArthritis international Society; EULAR=European League Against Rheumatism; HLA=human leukocyte antigen; MRI=magnetic resonance imaging.

References: 1. Martindale J, Goodacre L. The journey to diagnosis in AS/axial SpA: the impact of delay. Musculoskeletal Care. 2014;12(4):221-231. 2. Gladman DD, Antoni C, Mease P, Clegg DO, Nash P. Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis. 2005;64(suppl 2):ii14-ii17. 3. Feldtkeller E, Khan MA, van der Heijde D, van der Linden S, Braun J. Age at disease onset and diagnosis delay in HLA-B27 negative vs. positive patients with ankylosing spondylitis. Rheumatol Int. 2003;23(2):61-66. 4. Haroon M, Kirby B, FitzGerald O. High prevalence of psoriatic arthritis in patients with severe psoriasis with suboptimal performance of screening questionnaires. Ann Rheum Dis. 2013;72(5):736-740. 5. Rudwaleit M, Khan MA, Sieper J. The challenge of diagnosis and classification in early ankylosing spondylitis: do we need new criteria? Arthritis Rheum. 2005;52(4):1000-1008. 6. Rudwaleit M, van der Heijde D, Landewé R, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68(6):777-783. 7. Mandl P, Navarro-Compán V, Terslev L, et al. EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice. Ann Rheum Dis. 2015;74(7):1327-1339. 8. Assessment of SpondyloArthritis international Society. Ankylosing spondylitis disease activity score calculator. Assessment of SpondyloArthritis international Society website. http://www.asas-group.org/clinical-instruments/asdas_calculator/asdas.html. Updated July 6, 2015. Accessed September 17, 2015.