Non-radiographic axial spondyloarthritis

Mechanism and manifestations

Inflammatory pain, stiffness and extra-articular manifestations may occur. Normal radiographs do not exclude disease; conversely, an isolated MRI high-signal finding does not automatically establish diagnosis.

Diagnosis and management

Rheumatology assessment integrates history, examination, laboratory findings and sometimes sacroiliac MRI. Appropriate activity and anti-inflammatory or targeted medicines are discussed medically. Complementary care may support function without replacing inflammation control.

Points to consider

Infection and inflammatory disease require different treatments. Fever, immunosuppression, infection history, unusual pain and neurological deficits influence urgency. Absence of fever does not exclude infection. Physical modalities must not delay necessary medical investigation.

Role of TAGMED care

This condition first requires medical diagnosis and, depending on the situation, specialist management. TAGMED services do not replace treatment of infection or tumor, stabilization of an unstable injury, or neurological or vascular treatment. Any conservative support should be considered only after diagnosis, restrictions and the treating team’s recommendations have been clarified.

Related concepts and distinctions

These concepts belong to the same field, but are not synonyms.

• Cervical involvement in rheumatoid arthritis — Inflammatory cervical joint and ligament involvement in rheumatoid arthritis, potentially causing atlantoaxial instability among other changes.
• Septic facet joint arthritis — Infection of a vertebral facet joint that may spread into paraspinal tissues or the epidural space.
• Spinal tuberculosis — Spinal infection caused by Mycobacterium tuberculosis, potentially destroying vertebrae and causing abscess, deformity or neurological compression.

Medical references

1. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Ankylosing Spondylitis.
2. American College of Radiology / RSNA, RadiologyInfo. Spine MRI.

References document the topic; their inclusion does not imply endorsement of TAGMED services by those organizations.