Consensus statement on the investigation and management of non-radiographic axial spondyloarthritis (nr-axSpA)

Robinson, Philip C., Bird, Paul, Lim, Irwin, Saad, Nivene, Schachna, Lionel, Taylor, Andrew L., Whittle, Samuel L., & Brown, Matthew A. (2014) Consensus statement on the investigation and management of non-radiographic axial spondyloarthritis (nr-axSpA). International Journal of Rheumatic Diseases, 17(5), pp. 548-556.

View at publisher



Non-radiographic axial spondyloarthritis (nr-axSpA) is axial inflammatory arthritis where plain radiographic damage is not evident. An unknown proportion of these patients will progress to ankylosing spondylitis (AS). The increasing recognition of nr-axSpA has been greatly assisted by the widespread use of magnetic resonance imaging. The aim of this article was to construct a set of consensus statements based on a literature review to guide investigation and promote best management of nr-axSpA.


A literature review using Medline was conducted covering the major investigation modalities and treatment options available. A group of rheumatologists and a radiologist with expertise in investigation and management of SpA reviewed the literature and formulated a set of consensus statements. The Grade system encompassing the level of evidence and strength of recommendation was used. The opinion of a patient with nr-axSpA and a nurse experienced in the care of SpA patients was also sought and included.


The literature review found few studies specifically addressing nr-axSpA, or if these patients were included, their results were often not separately reported. Fourteen consensus statements covering investigation and management of nr-axSpA were formulated. The level of agreement was high and ranged from 8.1 to 9.8. Treatment recommendations vary little with established AS, but this is primarily due to the lack of available evidence on the specific treatment of nr-axSpA.


The consensus statements aim to improve the diagnosis and management of nr-axSpA. We aim to raise awareness of this condition by the public and doctors and promote appropriate investigation and management.

Impact and interest:

3 citations in Scopus
Search Google Scholar™
3 citations in Web of Science®

Citation counts are sourced monthly from Scopus and Web of Science® citation databases.

These databases contain citations from different subsets of available publications and different time periods and thus the citation count from each is usually different. Some works are not in either database and no count is displayed. Scopus includes citations from articles published in 1996 onwards, and Web of Science® generally from 1980 onwards.

Citations counts from the Google Scholar™ indexing service can be viewed at the linked Google Scholar™ search.

ID Code: 89069
Item Type: Journal Article
Refereed: Yes
Keywords: Ankylosing spondylitis, Non-radiographic axial spondyloarthritis, Spondyloarthritis, Tumor necrosis factor-alpha inhibitors, article, awareness, consensus, non radiographic axial spondyloarthritis, nurse practitioner, patient care, practice guideline, priority journal, radiologist, rheumatoid arthritis, rheumatology, self report, spondylarthritis, disease course, evidence based medicine, human, nuclear magnetic resonance imaging, nursing, predictive value, radiography, standards, treatment outcome, Disease Progression, Evidence-Based Medicine, Humans, Magnetic Resonance Imaging, Predictive Value of Tests
DOI: 10.1111/1756-185X.12358
ISSN: 1756-1841
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Deposited On: 15 Oct 2015 02:17
Last Modified: 18 Feb 2016 02:51

Export: EndNote | Dublin Core | BibTeX

Repository Staff Only: item control page