Doctor's Notes on Non-Radiographic Axial Spondyloarthritis (nr-axSpA)
Non-radiographic axial spondyloarthritis (nr-axSpA) is a diagnosis that doctors give to patients who have symptoms (for example, chronic [3 months or longer] back pain in the spine) of ankylosing spondylitis (AS) with no X-ray findings. In contrast, AS, as part of the criteria for diagnosis, shows X-ray changes in the spine joints. Some doctors consider nr-axSpA to be an early and/or less severe form of AS. The signs and symptoms of nr-axSpA may include chronic back pain and some of the following:
- There may be back pain, especially in the axial (spine) joints of the sacroiliac joints due to inflammation.
- Back pain and/or stiffness is worse at night or in the morning and may feel better after exercise.
- Back pain begins in teen or young adults and usually before age 40.
- There are no X-ray findings on routine axial X-rays.
- MRIs may show some axial joint tendon swelling.
- Other joints may show tendon swelling.
- Some individuals may have uveitis (eye inflammation, redness, an blurry vision).
- Patients with psoriatic arthritis and enteropathic arthritis commonly have nr-axSpA.
The cause of nr-axSpA is not known. However, most researchers consider that genetics and environmental interactions that can trigger inflammation cause the disease. The prevalence is somewhat unclear because the data is limited. However, estimates range between 15%-24% among those seeking a back pain diagnosis from general practitioners and rheumatologists.
Ankylosing Spondylitis : Symptoms & Treatment QuizQuestion
Ankylosing spondylitis is a type of __________ that affects the __________.See Answer
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Ankylosing Spondylitis (AS) MedicationsAnkylosing spondylitis is a form of arthritis that affects the spine, sacroiliac joints and leg joints. Symptoms include: low back pain; eye pain; pain and tenderness of the joints, including; ribs, shoulder blades, hips, thighs, and bony points of the spine. Because ankylosing spondylitis is incurable, treatment focuses on lessening pain and keeping mobility with exercise, heat and cold, and the use of various medications.
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Low Back PainBack pain may be caused by sciatica, a herniated disc, spinal stenosis, fibromyalgia, injury and pregnancy. The pain usually radiates down the legs, pain that gets worse with activity or at night, or numbness or weakness in the leg. Treatment may involve sleeping with a pillow between the knees or taking ibuprofen or acetaminophen.
Magnetic Resonance Imaging (MRI)Magnetic resonance imaging (MRI) is a scanner that takes cross-sectional images of the body. It is used to evaluate tissues of the head, neck, chest, limbs, abdomen, and pelvis. MRI is a very safe procedure; sedation may be used for infants, small children, or adults who are claustrophobic.
What Are the First Signs of Rheumatoid Arthritis?Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by persistent joint pain, swelling, and stiffness. It can also affect the skin, heart, lungs, and eyes. Rheumatoid arthritis differs from some other forms of arthritis because it affects both sides of the body. The most common form of arthritis, osteoarthritis, may affect only one side of the body and is a degenerative condition.
X-RaysX-Rays are a form of radiation used to image solid forms inside the body. X-rays are administered by radiologists for many different routine tests, such as mammograms, checking for broken bones, upper GI series, and dental exams, among others. Radiologists carefully monitor the X-ray equipment to make sure the patient receives the smallest dose of radiation possible.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.