Spondyloarthritis: diagnosis and management: summary of NICE guidance
Spondyloarthritis: diagnosis and management: summary of NICE guidance
复制标题
脊柱关节炎：诊断和治疗：NICE 指南摘要
作者：
K. McAllister;N. Goodson;L. Warburton;G. Rogers
#你需要知道什么
脊柱关节炎包括一组具有一些共同特征的炎症性疾病，包括可能在最初或之后出现的关节外表现。该指南区分了外周性和轴性疾病（见方框1）。
####方框1：脊柱关节炎的类型
#主要轴向
#主要是外围设备
注：主要为轴性脊柱关节炎也可能有外周特征，反之亦然
非专业设置的医疗保健专业人员经常无法识别脊柱关节炎的体征和症状。脊柱关节炎的轴位表现经常被误诊为机械性腰痛，导致有效治疗的延迟。从症状出现到诊断平均延迟8.5年，只有大约15%的病例在初次就诊后3个月内得到诊断。1与常见的误解相反，中轴性脊柱关节炎影响的女性和男性人数相似，在X线平片上并不总是明显，并且发生在人类白细胞抗原血清阴性的人群中。
#### What you need to know
Spondyloarthritis encompasses a group of inflammatory conditions with some shared features, including extra-articular manifestations that may occur at initial presentation or later. The guideline distinguishes between peripheral and axial disease (see box 1).
#### Box 1: Types of spondyloarthritis
##### Predominantly axial
##### Predominantly peripheral
Note: Predominantly axial spondyloarthritis may also have peripheral features, and vice versa
Healthcare professionals in non-specialist settings frequently fail to recognise signs and symptoms of spondyloarthritis. Axial presentations of spondyloarthritis are often misdiagnosed as mechanical low back pain, leading to delays in access to effective treatments. There is an average delay of 8.5 years between symptom onset and diagnosis, with only around 15% of cases receiving a diagnosis within three months of initial presentation.1 Contrary to common misconceptions, axial spondyloarthritis affects similar numbers of women and men, is not always apparent on plain x ray, and occurs in people who are seronegative for human leucocyte antigen …