Trial reportAnnals of the rheumatic diseases2011
Identifying patients with axial spondyloarthritis in primary care: how useful are items indicative of inflammatory back pain?
Trial report in Annals of the rheumatic diseases, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
47 citing papers in PubMed, 3 syntheses or guidelines pooled it, 117 citations in OpenAlex.
- Ankylosing spondylitis risk factors: a systematic literature review.Clinical rheumatology · 2021Pooled it
- [Long version on the S3 guidelines for axial spondyloarthritis including Bechterew's disease and early forms, Update 2019 : Evidence-based guidelines of the German Society for Rheumatology (DGRh) and participating medical scientific specialist societies and other organizations].Zeitschrift fur Rheumatologie · 2019Guideline
- [German Society for Rheumatology S3 guidelines on axial spondyloarthritis including Bechterew's disease and early forms: 5 Initial diagnosis/referral strategy].Zeitschrift fur Rheumatologie · 2014Guideline
- HLA-B27 detection test for individuals with suspected axial spondyloarthritis to Brazilian public health system: accuracy, cost-effectiveness, and budget impact analysis.GMS health innovation and technologies · 2026Article
- Design and validation of a referral algorithm for inflammatory arthritis and low back pain: identifying gaps in primary care practices.Clinical rheumatology · 2026Article
- Prevalence of axial spondyloarthritis (axSpA) in patients treated for chronic back pain in chiropractic clinics: the oregon chiropractic axial spondyloarthritis study (ORCAS).Clinical rheumatology · 2025Observational
- Orthopaedic physicians' awareness, diagnostic challenges and referral barriers in axial spondyloarthritis: insights from a nationwide survey in Germany.Therapeutic advances in musculoskeletal disease · 2025Article
- A scoping review of triage approaches for the referral of patients with suspected inflammatory arthritis, from primary to rheumatology care.Rheumatology international · 2024Article
- Regional Differences in Diagnosis Journey and Healthcare Utilization: Results from the International Map of Axial Spondyloarthritis (IMAS).Rheumatology and therapy · 2024Article
- [The role of HLA-B27 in the pathogenesis and diagnosis of axial spondyloarthritis : 50 years after discovery of the strong genetic association].Zeitschrift fur Rheumatologie · 2024Review
- Diagnosis Value of Patient Evaluation Components Applicable in Primary Care Settings for the Diagnosis of Low Back Pain: A Scoping Review of Systematic Reviews.Journal of clinical medicine · 2023Article
- Article
- Axial Spondyloarthritis and Diagnostic Challenges: Over-diagnosis, Misdiagnosis, and Under-diagnosis.Current rheumatology reports · 2023Review
- Burden of disease and impact on quality of life in chronic back pain - a comparative cross-sectional study of 150 axial spondyloarthritis and 150 orthopedic back pain patients.Frontiers in medicine · 2023Article
- Early identification of axial spondyloarthritis in a multi-ethnic Asian population.Clinical rheumatology · 2022Article
- Differentiating nonradiographic axial spondyloarthritis from its mimics: a narrative review.BMC musculoskeletal disorders · 2022Review
- Development and test-retest reliability of a screening tool for axial spondyloarthritis.PloS one · 2022Article
- Axial Psoriatic Disease: Clinical and Imaging Assessment of an Underdiagnosed Condition.Journal of clinical medicine · 2021Review
- Treatment of Connective Tissue Disease-Related Intractable Disease with Biological Therapeutics.Open access rheumatology : research and reviews · 2021Review
- Evaluating Inflammatory Versus Mechanical Back Pain in Individuals with Psoriatic Arthritis: A Review of the Literature.Rheumatology and therapy · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe value of clinical items defining inflammatory back pain to identify patients with axial spondyloarthritis (SpA) in primary care is unclear.
objectiveTo identify predictive clinical parameters for a diagnosis of axial SpA in patients with chronic back pain presenting in primary care.
methodsConsecutive patients aged < 45 years (n=950) with back pain for > 2 months who presented to orthopaedic surgeons (n=143) were randomised based on four key questions for referral to rheumatologists (n=36) for diagnosis.
resultsThe rheumatologists saw 322 representative patients (mean age 36 years, 50% female, median duration of back pain 30 months). 113 patients (35%) were diagnosed as axial SpA (62% HLA B27+), 47 (15%) as ankylosing spondylitis (AS) and 66 (21%) as axial non-radiographic SpA (nrSpA). Age at onset ≤ 35 years, improvement by exercise, improvement with non-steroidal anti-inflammatory drugs, waking up in the second half of the night and alternating buttock pain were identified as most relevant for diagnosing axial SpA by multiple regression analysis. Differences between AS and nrSpA were detected. No single item was predictive, but ≥ 3 items proved useful for good sensitivity and specificity by receiver operating characteristic modelling.
conclusionThis study shows that a preselection in primary care of patients with back pain based on a combination of clinical items is useful to facilitate the diagnosis of axial SpA.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.