Non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) are two forms of axial spondyloarthritis with many overlapping symptoms. The main difference is what an X-ray shows. AS causes definite changes in the sacroiliac joints that can be seen on X-ray, while nr-axSpA does not.
Some people with nr-axSpA go on to develop AS, but many do not. Studies estimate that about 5% to 30% of people with nr-axSpA progress to AS over two to 30 years. Even without this progression, nr-axSpA can cause symptoms as severe as those experienced by people with AS.
A normal X-ray does not rule out nr-axSpA. Diagnosis is based on a combination of symptoms, physical exam, medical and family history, blood tests, and imaging.
Yes. Although nr-axSpA does not cause definitive changes in the sacroiliac joints that can be seen on X-rays, an MRI can detect inflammation in those joints. This can help doctors identify nr-axSpA earlier, before structural changes become visible on X-rays.
Non-radiographic axial spondyloarthritis often feels like ongoing pain and stiffness in the lower back and buttocks. These feelings tend to be worse in the morning or at night and may improve with movement or exercise rather than rest. However, the pain can also affect the neck, hips, shoulders, ribs, knees, or heels, and some people experience fatigue or inflammation in the eyes, skin, or digestive system.
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