According to the CDC’s 2012 NHANES study, axial spondyloarthritis (axSpA) – an inflammatory rheumatic disease – affects roughly 3.2 million adults in the U.S. alone, making it more common than rheumatoid arthritis. Despite this reality, axSpA is not always well understood by the general public or even medical professionals.
AxSpA is often difficult to diagnose partly because its most common symptom, back pain, is a pervasive patient complaint. This partially explains why it can take up to 10 years to obtain the correct diagnosis. One helpful clue, however is the presence of inflammatory back pain.
Below we present axSpA resources specifically geared to Primary Care Physicians and other health care professionals working in the primary care setting.
Now Offering Continuing Education Hours for Primary Care Providers (ACCME)!
Credit Available
All other health care professionals completing this course will be issued a statement of participation.
Target Audience
This activity is designed to meet the educational needs of Primary Care Physicians, Physician Assistants and Nurse Practitioners.
Program Overview
This activity will help increase knowledge and awareness of axial spondyloarthritis (axSpA) among Primary Care providers, giving them tools to appropriately suspect, diagnose, and refer axSpA patients to rheumatology, with the ultimate goal of improving patient outcomes.
This activity is supported by The Spondylitis Association of America.
*This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of EXCEL Continuing Education and The Spondylitis Association of America. EXCEL Continuing Education is accredited by the ACCME to provide continuing medical education for physicians.
Here are three different criteria that can help determine if your patient may have IBP:
IBP if 4 / 5 are present.
IBP if 2 / 4 are present.
IBP if 4 / 5 are present.
Most cases of spondyloarthritis can be diagnosed or, at least, initially suspected, based on medical history and clinical examination.
Inflammation of the entheses, where joint capsules, ligaments, or tendons attach to bone. This can be felt in multiple areas of the body from shoulders down to the feet.
Inflammation of an entire digit (a finger or toe.)
Inflammation of the eye. Symptoms often occur in one eye at a time, and they may include redness, pain, sensitivity to light, and skewed vision.
Bloodwork may not always be helpful in screening for SpA, as many of the usual inflammatory markers are missing. SpA is seronegative (a negative blood test result), and has no association with rheumatoid factor or antinuclear antibodies. The presence of the HLA-B27 gene marker, however, can be a very helpful clue, though not everyone with SpA will test positive for this marker.
Also, common indicators of systemic inflammation, such as an elevated erythrocyte sedimentation rate (ESR/SED rate) and elevated C-reactive protein (CRP) are not always present in SpA patients.
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