Neurológia pre prax 5/2018

When to consider inflammatory rheumatic disease in the differential diagnosis of back pain?

Aim: To highlight the need for early diagnosis of inflammatory rheumatic causes of back pain that, due to their rare occurrence, tend to be overlooked easily in patients with back pain. Summary: The group of inflammatory rheumatic diseases of the back (spondyloarthritides /SpA/) include autoimmune inflammatory diseases wherein the inflammation affects the axial skeleton, root joints, and peripheral joints, predominantly in the lower limbs. The most common disease of the SpA group is ankylosing spondylitis (Bechterew’s disease). The diagnosis of ankylosing spondylitis has been based on the 1984 modified New York criteria which require radiographic confirmation of injury to the sacroiliac joints. The author aims to highlight in the article that the use of novel diagnostic methods has fundamentally changed the approach to this disease, and presents an overview of the current classification criteria that allow for detection of the disease prior to developing permanent structural changes. Conclusion: Early diagnosis allows for a rapid commencement of adequate treatment that can significantly affect the further course of the disease.

Keywords: back pain, axial spondyloarthritis, ankylosing spondylitis