Spondyloarthritis: diagnosis and management: summary of NICE guidance

#### 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 …