Swedish Medical Center/Providence St. Joseph Health and University of Washington, Seattle Rheumatology Associates, WA, Seattle, USA.
Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, Portland, OR, USA.
BMC Musculoskelet Disord. 2022 Mar 12;23(1):240. doi: 10.1186/s12891-022-05073-7.
Optimal treatment of nonradiographic axial spondyloarthritis depends on accurate and timely diagnosis of the underlying disease; however, patients present with common symptoms that, in the absence of radiographic changes, may confound diagnosis.
In this narrative review, a PubMed literature search was conducted through January 2021, with no date limits, to identify English-language publications discussing classification of nonradiographic axial spondyloarthritis, with an emphasis on clinical features and presentation, differential diagnoses, and mimics of disease. This review describes the epidemiology, clinical features, and burden of disease of nonradiographic axial spondyloarthritis as it relates to the overall axial spondyloarthritis spectrum and discusses mimics and differential diagnoses of nonradiographic axial spondyloarthritis that should be considered when evaluating patients with suspected nonradiographic axial spondyloarthritis in clinical practice.
Recognition of clinical features of nonradiographic axial spondyloarthritis, along with an understanding of comorbid conditions such as fibromyalgia, allows for differentiation from its mimics. Appropriate diagnosis of nonradiographic axial spondyloarthritis is important for aggressive management of disease to reduce pain, avoid loss of function, and improve quality of life.
非影像学轴性脊柱关节炎的最佳治疗取决于对潜在疾病的准确和及时诊断；然而，患者表现出常见的症状，如果没有影像学改变，可能会混淆诊断。
在这篇叙述性综述中，我们通过 2021 年 1 月进行了一次 PubMed 文献检索，没有时间限制，以确定讨论非影像学轴性脊柱关节炎分类的英语出版物，重点是临床特征和表现、鉴别诊断和疾病的模拟。本综述描述了非影像学轴性脊柱关节炎的流行病学、临床特征和疾病负担，因为它与整体轴性脊柱关节炎谱有关，并讨论了在临床实践中评估疑似非影像学轴性脊柱关节炎患者时应考虑的非影像学轴性脊柱关节炎的模拟和鉴别诊断。
认识到非影像学轴性脊柱关节炎的临床特征，以及对纤维肌痛等合并症的理解，有助于将其与模拟区分开来。对非影像学轴性脊柱关节炎的正确诊断对于积极管理疾病以减轻疼痛、避免功能丧失和提高生活质量非常重要。
