Rheumatology Department, Norfolk and Norwich Hospital, Colney Lane, Norwich, UK.
Curr Opin Rheumatol. 2021 Jul 1;33(4):319-325. doi: 10.1097/BOR.0000000000000807.
The concept of inflammatory back pain (IBP) describes a cohort of patients with chronic back pain (CBP) who have distinct clinical characteristics, rather than being a diagnosis in and of itself. IBP is a common and important feature of axial spondyloarthritis (axSpA) but this is not the only differential. This review examines the utility of IBP in both primary and secondary care settings.
There are a number of suggested referral strategies for patients with suspected axSpA that include IBP. These strategies attempt to strike a balance between ensuring potential axSpA patients are not overlooked, whilst simultaneously not overwhelming secondary care services. Their success relies on the clinicians who first encounter these patients being familiar with IBP as a concept; however, it is still poorly recognized by many healthcare professionals. IBP may be helpful as part of a referral strategy; however, other clinical features, laboratory investigations and radiology must be incorporated for the final diagnostic outcome in axSpA.
Delayed diagnosis is a major clinical problem in axSpA and is associated with worse clinical outcomes. When recognized and utilized correctly, IBP can be a useful tool to promote prompt referral to rheumatology services.
综述目的：炎症性背痛（IBP）的概念描述了一组慢性背痛（CBP）患者，他们具有独特的临床特征，而不仅仅是一种诊断。IBP 是中轴型脊柱关节炎（axSpA）的常见且重要特征，但这不是唯一的鉴别点。本文综述了 IBP 在初级和二级保健环境中的应用。
**最新发现：对于疑似 axSpA 的患者，有许多建议的转诊策略，其中包括 IBP。这些策略试图在确保潜在 axSpA 患者不被忽视与同时不过度使用二级保健服务之间取得平衡。这些策略的成功取决于首次接触这些患者的临床医生对 IBP 这一概念的熟悉程度；然而，许多医疗保健专业人员仍对此认识不足。IBP 可能有助于作为转诊策略的一部分；然而，在 axSpA 的最终诊断结果中，还必须结合其他临床特征、实验室检查和影像学检查。
总结：axSpA 的诊断延迟是一个主要的临床问题，与更差的临床结局相关。当正确识别和使用时，IBP 可以成为促进及时转至风湿病科就诊的有用工具。
