Axial spondyloarthritis (axSpA) can be identified with or without imaging1

Due to the lack of early radiographic evidence, identifying non-radiographic axSpA (nr-axSpA) requires clinical diagnosis of inflammatory back pain (IBP) together with recognition of other SpA features.1 See SpA features

Identifying axSpA using the ASAS classification criteria1,2


Image of flowchat depicting routes to suspected diagnosis of axSpA

Adapted from Sieper J, et al. 2015.
*Other causes of signs and symptoms should always be excluded.3


The probability that a person has axSpA increases with the number of SpA features present3

SpA features1

A common symptom of nr-axSpA is IBP, which can lead to pain experienced at night time.5

Diagram of annotated male and female skeletons


Identifying IBP

Image detailing paragraphs of IBP identification


Image of arrow with link to Gender differences


ASAS, Assessment of SpondyloArthritis international Society criteria; axSpA, axial spondyloarthritis; CRP, C-reactive protein; HLA-B27, human leukocyte antigen B27; IBP, inflammatory back pain; MRI, magnetic resonance imaging; nr-axSpA, non-radiographic axial spondyloarthritis; NSAIDs, nonsteroidal anti-inflammatory drugs; SpA, spondyloarthritis; UC, ulcerative colitis.


  1. Rudwaleit M, et al. Ann Rheum Dis. 2009;68(6):777–783.
  2. Sieper J, et al. Nat Rev Dis Primers. 2015;1:1–16.
  3. Rudwaleit M, et al. Arthritis Rheum. 2005;52(4):1000–1008.
  4. Vidal C, et al. Joint Bone Spine. 2018;85(4):461–468.
  5. Strand V & Singh JA. Mayo Clin Proc. 2017;92(4):555–564.
  6. Chakrabarty S & Zoorob R. Am Fam Physician. 2007;76(2):247–254.
  7. Sieper J & Rudwaleit M. Ann Rheum Dis. 2005;64(5):659–663.
Rate this content: 
No votes yet
UK | April 2021 | 114841

Ask Speakers


Medical Information Request

Adverse events should be reported. Reporting forms and information can be found at Adverse events should also be reported to Novartis via [email protected] or online through the pharmacovigilance intake (PVI) tool at
If you have a question about the product, please contact Medical Information on 01276 698370 or by email at [email protected]