We’re here to help you understand axial spondyloarthritis (axSpA). It’s a chronic disease that mainly affects the spine and sacroiliac joints. It’s a big health issue, with rates around the world from 0.007 to 1.7 percent. Getting a diagnosis and treatment early is key.
Axial spondyloarthritis has two main types: radiographic axSpA, also known as ankylosing spondylitis, and non-radiographic axSpA. Knowing the difference is important. It helps doctors decide the best treatment and improves how patients feel.
We’re dedicated to top-notch healthcare at our institution. We support patients from all over. By understanding axSpA and its types, we can tailor care to meet each patient’s needs.
Key Takeaways
- Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that mainly affects the spine and sacroiliac joints.
- axSpA has two main types: radiographic axSpA (ankylosing spondylitis) and non-radiographic axSpA.
- Knowing the difference between these types is key for choosing the right treatment.
- Global rates of axSpA range from 0.007 to 1.7 percent.
- Early diagnosis and treatment are vital for better patient outcomes.
Understanding Axial Spondyloarthritis (axSpA) as a Spectrum

Axial spondyloarthritis (axSpA) is a condition that varies in severity and symptoms. It’s important to see it as a spectrum for diagnosis and treatment. This view helps in understanding the range of clinical features and symptoms.
Definition and Classification System
Axial spondyloarthritis mainly affects the spine and sacroiliac joints. It has radiographic and non-radiographic forms, based on X-ray findings. The Assessment of SpondyloArthritis international Society (ASAS) criteria are used for classification. They look for sacroiliitis on imaging or HLA-B27 antigen with typical symptoms.
The ASAS criteria help in early diagnosis and treatment. This is key for non-radiographic axSpA, where symptoms are present but X-rays show no damage.
Global Prevalence Rates
The prevalence of axial spondyloarthritis varies worldwide. It ranges from 0.007% to 1.7%. This difference is due to genetics, like HLA-B27, and demographics. Studies show axSpA affects both men and women, but men are more likely to have the radiographic form.
Common Clinical Features and Symptoms
The symptoms of axial spondyloarthritis vary among patients. Common symptoms include:
- Inflammatory back pain: Chronic pain and stiffness in the lower back, worse after rest.
- Enthesitis: Inflammation where tendons or ligaments attach to bone, often in the heels and soles.
- Extra-articular manifestations: Symptoms outside the joints, like anterior uveitis, psoriasis, and inflammatory bowel disease.
Other symptoms include heel soreness, pain and swelling in fingers or toes, and fatigue. The wide range of symptoms emphasizes the need for a thorough assessment for diagnosis and management.
Seeing axial spondyloarthritis as a spectrum helps healthcare providers tailor care. This personalized approach is vital for better outcomes and quality of life for those with axSpA.
Ankylosing Spondylitis: The Radiographic Form of axSpA

Ankylosing spondylitis is a type of axial spondyloarthritis. It shows clear damage to the sacroiliac joints on X-rays. This makes it different from non-radiographic axial spondyloarthritis.
Structural Damage in Sacroiliac Joints
Ankylosing spondylitis causes serious damage to the sacroiliac joints. This damage includes erosions, sclerosis, and ankylosis. These changes are seen on X-rays.
The damage comes from long-term inflammation. It can lead to the joints fusing together. This can make it hard to move and can affect a person’s quality of life.
X-ray Findings and Diagnostic Criteria
To diagnose ankylosing spondylitis, doctors look at X-rays. They use the modified New York criteria. This includes:
- Radiographic evidence of sacroiliitis (grade 2 or higher bilaterally or grade 3 or 4 unilaterally)
- At least one clinical criterion, such as inflammatory back pain, limited spinal mobility, or reduced chest expansion
These criteria help doctors tell ankylosing spondylitis apart from other forms of axial spondyloarthritis, like non-radiographic axSpA.
Demographics and Gender Distribution
Ankylosing spondylitis mostly affects men. The ratio of men to women is usually 2:1 to 3:1. It often starts in late teens or early twenties.
Knowing who is more likely to get ankylosing spondylitis helps doctors catch it early. It’s important for them to keep this in mind when checking patients with symptoms of axial spondyloarthritis.
Non-Radiographic axSpA vs. Ankylosing Spondylitis: Key Differences
It’s important to know the differences between non-radiographic axial spondyloarthritis and ankylosing spondylitis. This knowledge helps in making the right diagnosis and treatment plan. We will look at how these two conditions differ, focusing on their imaging, symptoms, and how the disease progresses.
Imaging Distinctions
The main difference is in the imaging findings. Non-radiographic axSpA shows no structural damage on X-ray but has inflammatory changes on MRI. On the other hand, ankylosing spondylitis has clear structural damage on X-ray, along with inflammatory changes.
Here’s a comparison of the imaging findings:
| Imaging Modality | Non-Radiographic axSpA | Ankylosing Spondylitis |
| X-ray | No structural damage | Definitive structural damage |
| MRI | Inflammatory changes present | Inflammatory changes present |
Symptom Comparison and Disease Burden
Both conditions share similar symptoms like chronic back pain, stiffness, and fatigue. But, the disease burden can differ. Ankylosing spondylitis tends to have more severe symptoms and a higher risk of disability due to its progressive nature.
Here’s a comparison of symptoms:
| Symptom | Non-Radiographic axSpA | Ankylosing Spondylitis |
| Chronic Back Pain | Present | Present |
| Stiffness | Present | Present |
| Fatigue | Present | Present |
| Disability Risk | Lower | Higher |
Disease Progression Patterns
Not all non-radiographic axSpA patients will develop ankylosing spondylitis. Studies indicate that some patients may progress within a few years. The risk of progression depends on certain biomarkers and the severity of symptoms at the start.
Early diagnosis and treatment are key. They can help slow down disease progression and improve outcomes for patients.
Conclusion
We’ve looked into the differences between axial spondyloarthritis (axSpA) and ankylosing spondylitis. AxSpA includes both forms with and without visible damage on X-rays. Ankylosing spondylitis is a type of axSpA that shows damage in the sacroiliac joints.
The main difference is whether there’s visible damage on X-rays. Ankylosing spondylitis has this damage. But both conditions have similar symptoms like back pain and stiffness.
It’s important to know about axSpA’s different forms for correct diagnosis and treatment. As we learn more about rheumatology, we can give better care to those with xspa. This means treating each person based on their specific needs.