ReviewClinical rheumatology2019
Axial spondyloarthritis in the USA: diagnostic challenges and missed opportunities.
Review in Clinical rheumatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers.
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.
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Who cites it
52 citing papers in PubMed, 89 citations in OpenAlex.
- No major effect of age (< 40 vs. ≥ 40 years) on response to secukinumab in patients with axSpA: a post hoc analysis of six phase 3 trials.Arthritis research & therapy · 2026Trial
- Research on automatic recognition radiomics algorithm for early sacroiliac arthritis based on sacroiliac MRI imaging.Journal of orthopaedic surgery and research · 2024Trial
- The journey of Europeans with musculoskeletal complaints: the creation of the SPIDeRR's personas.EULAR rheumatology open · 2026Article
- Time and patient journey to axial spondyloarthritis diagnosis: a retrospective study in French primary care.Rheumatology (Oxford, England) · 2026Article
- Treatment satisfaction, disease severity, and health-care use in patients with axial spondyloarthritis in the United States and Europe.Rheumatology (Oxford, England) · 2026Article
- Time-efficient MRI scoring system for axial spondyloarthritis: a feasibility study.European radiology · 2026Article
- Assessment of public knowledge and awareness regarding rheumatological diseases: a cross-sectional study.Reumatologia · 2026Article
- MRI-defined sacroiliitis and spinal inflammation in chronic back pain: real-world patterns in axial spondyloarthritis and axial psoriatic arthritis.Rheumatology advances in practice · 2026Article
- A comprehensive evaluation of radiographic trochanteric enthesitis in axial spondyloarthritis : Prevalence, disease activity, and functional impairments.Zeitschrift fur Rheumatologie · 2025Observational
- 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
- The patient journey in rheumatic and musculoskeletal diseases: a systematic review.EULAR rheumatology open · 2025Article
- The journey of patients with musculoskeletal complaints in Europe: a cross-sectional European survey.Rheumatology international · 2025Article
- Disparities in Time to Diagnosis of Radiographic Axial Spondyloarthritis.The Journal of 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
- Early diagnosis of axial spondyloarthritis among patients with chronic back pain using a clinical screening tool and referral strategy.Rheumatology advances in practice · 2025Article
- Canadian Patients With Axial Spondyloarthritis Require Almost a Decade To Be Diagnosed Leading to Severe Functional Limitation. Results From the International Map of Axial Spondyloarthritis (IMAS).Musculoskeletal care · 2024Article
- Article
- An update on the management of axial spondyloarthritis for sports medicine professionals.BMC sports science, medicine & rehabilitation · 2024Review
- Ixekizumab Treatment Patterns and Health Care Resource Utilization Among Patients with Axial Spondyloarthritis: A Retrospective United States Claims Database Study.Rheumatology and therapy · 2024Article
- A qualitative exploration of the patient journey in axial spondyloarthritis towards a people-centered understanding.Scientific reports · 2024Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease that primarily affects the sacroiliac joints and spine. Delayed or inadequate treatment may decrease quality of life and lead to poor long-term outcomes, including irreversible loss of spinal function. In this review, we discuss clinical practice related to axSpA within the USA, including prevalence, diagnosis, reasons for delayed/missed diagnosis, and suggestions for making early diagnosis. The US population prevalence of axSpA (0.9-1.4%) is higher than the diagnostic prevalence (0.2-0.7%). Although the estimated diagnostic delay for axSpA is 14 years in the USA, the disease can be identified earlier if appropriately preselected patients are quickly referred to rheumatologists. Only 37% of patients with ankylosing spondylitis in the USA are diagnosed by rheumatologists; the remaining 63% are diagnosed by primary care (26%), chiropractic/physical therapy (7%), orthopedic surgery (4%), pain clinics (4%), acute care (3%), and other settings (19%). To help reduce diagnostic delay, non-rheumatologist-healthcare professionals are urged to refer patients with back pain and ≥ 1 of 3 SpA features (HLA-B27 positivity, current inflammatory back pain, or x-ray/MRI evidence of sacroiliitis) to a rheumatologist. Prevalence and diagnosis rates of axSpA are disparate in the USA due to the lack of awareness and knowledge among non-rheumatologists. Progress has been made in identifying hurdles causing diagnostic delays. Public health initiatives are needed to guide primary care physicians, physical therapists, chiropractors, and other specialists seeing patients with chronic back pain on methods for suspecting or identifying axSpA and early referral to rheumatologists.
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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.