Symptoms and Signs of Non-Radiographic Axial Spondyloarthritis (nr-axSpA)

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Medically Reviewed on 5/10/2022

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, and blurry vision).
  • Patients with psoriatic arthritis and enteropathic arthritis commonly have nr-axSpA.

What Are the Treatments for nr-axSpA?

The treatments for nr-axSpA are mainly anti-inflammatory medicines and physical therapy. Medicines range from over-the-counter NSAIDs to antirheumatic drugs:

Physical therapy is an ongoing treatment as it may reduce pain and promote a good range of motion for your joints. Also, your doctor may recommend combining drugs like NSAIDs and DMARDs.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.