Evidence-based recommendations for the diagnosis of ankylosing spondylitis: results from the Australian 3E initiative in rheumatology
Kain, T and Zochling, J and Taylor, Andrew and Manolios, N and Smith, MD and Reed, MD and Brown, MA and Schachna, L (2008) Evidence-based recommendations for the diagnosis of ankylosing spondylitis: results from the Australian 3E initiative in rheumatology. Medical Journal of Australia, 188 (4). pp. 235-237. ISSN 0025-729X
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Official URL: http://www.mja.com.au/public/issues/188_04_180208/kai10788_fm.html
• As part of the 3E program, we conducted a systematic
literature review and gathered consensus from 23 practising
Australian rheumatologists to develop guidelines for early
identification of ankylosing spondylitis and specialist referral.
• In three rounds of break-out sessions followed by discussion
and voting, the specialist panel addressed three questions
related to diagnosis of ankylosing spondylitis:
In individuals with back pain, what are the early clinical
features that suggest ankylosing spondylitis?
How useful is imaging in identifying early ankylosing
Based on which clinical features should a general
practitioner refer a patient to a rheumatologist for further
• The panel agreed on six recommendations related to the
1a. Early clinical features to suggest ankylosing spondylitis
include inflammatory back pain and age at symptom onset
1b. The absence of symptomatic response to an
appropriate course of non-steroidal anti-inflammatory drugs
makes the diagnosis of ankylosing spondylitis less likely.
1c. Raised inflammatory markers are supportive, but their
absence does not rule out the diagnosis of ankylosing
2a. Despite low sensitivity to detect changes of early
ankylosing spondylitis, plain radiographs of the pelvis and
spine are appropriate initial imaging techniques.
2b. Magnetic resonance imaging is a useful imaging
modality for detecting early changes of ankylosing
3. Individuals with inflammatory back pain should be
referred to a rheumatologist for further evaluation.
• Effective dissemination and implementation of these
recommendations are important to standardise the approach
MJA 2008; 188: 235–237
to early diagnosis of ankylosing spondylitis.
|Deposited By:||Ms Emma Stubbs|
|Deposited On:||24 Apr 2008 12:47|
|Last Modified:||18 Jul 2008 20:54|
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