Last updated:19th April 2016

Axial Spondyloarthritis

Axial Spondyloarthritis is still a relatively new term in rheumatology

Currently the formal diagnosis of ankylosing spondylitis (AS) relies on your rheumatologist seeing damage on x-ray of your sacroiliac joints. These changes are called sacroiliitis.

However it may take years for changes to show up on x-ray and some people may never show changes on x-ray. During this time you may be experiencing a lot of pain in your back.

Axial Spondyloarthritis or axial SpA for short (abbreviated as axSpA) refers to inflammatory disease where the main symptom is back pain, and where the x-ray changes of sacroiliitis may or may not be present.

Within axial SpA there are two groups:

Ankylosing Spondylitis (AS)

Where the x-ray changes are clearly present.

Non-radiographic axial spondyloarthritis (nr-axSpA)

Where x-ray changes are not present but you have symptoms.

Up to 70% of people in this group have visible inflammation in the sacroiliac joints and/or the spine when an MRI of the back is done.

30% of people in this group may not have any change visible on the MRI despite symptoms of back pain. In fact some of these patients may never show any inflammation on an MRI even if this is repeated later on in life. The reasons for this are still not well understood but may be due to how sensitive our methods to image the joints are. 

More information on axial spondyloarthritis

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