5/14/2025
Many doctors who treat chronic back pain may not recognize axial spondyloarthritis (axSpA), according to a new study led by Yale School of Medicine. The findings were recently published in the Journal of Rheumatology.
To better understand awareness of axSpA, researchers surveyed physicians across the U.S. about their knowledge, attitudes, and practices. The goal was to identify barriers to referral and to find ways to reduce the delay in diagnosing axSpA.
A total of 750 physicians (24% response rate) completed the online survey, including non-rheumatology providers (NRPs) who treat chronic back pain, such as those in primary care, orthopedics, spine surgery, pain management, and rehabilitation. Rheumatologists were also surveyed for comparison.
While 87% of NRPs could identify common features of inflammatory back pain (IBP), only 41% said they routinely assess for it. NPRs were less likely than rheumatologists to order appropriate tests like CRP and HLA-B27, instead favoring less relevant tests like ANA and rheumatoid factor.
Only 50% identified a pelvic or sacroiliac X-ray as the correct initial imaging for axSpA, and just 37% selected MRI of the pelvis as the appropriate follow-up. Additionally, 11% of NRPs were unfamiliar with the term axSpA, and 35% did not recognize the term non-radiographic axSpA. Many also reported being less likely to consider axSpA as a possible diagnosis in patients with chronic back pain.
The study found significant knowledge gaps among NRPs in axSpA terminology, testing, and imaging, which contributes to delayed diagnoses. Researchers recommend improved education and clear referral pathways to address these gaps.
References
Input your search keywords and press Enter.
