title: High Prevalence of Undiagnosed Axial Spondyloarthritis in Patients with Chronic Low Back Pain Consulting Non-Rheumatologist Specialists in Belgium: SUSPECT Study.
abstract: BACKGROUND
  Diagnosis of axial spondyloarthritis (SpA) can be delayed for several years mainly because of low awareness of axial SpA among non-rheumatologists who are the first interlocutors of potential SpA patients. One strategy to decrease the delay between appearance of first symptoms and diagnosis of axial SpA and to allow early management of the disease is to provide the non-rheumatologists with tools to identify patients requiring prompt referral to rheumatologists. This study was designed to evaluate in a real-world setting whether screening patients with chronic low back pain who consult physical medicine and rehabilitation (PMR) physicians, orthopedists, and ophthalmologists is useful in detecting axial SpA.
  
  
  METHODS
  During this non-interventional cross-sectional study, data from 161 patients with chronic back pain, consulting an orthopedist, PMR physician, or ophthalmologist were collected during a single visit. Any patient who presented with at least four out of five symptoms of inflammatory back pain (IBP) and at least one additional SpA feature were to be referred to a rheumatologist. Analysis was purely descriptive.
  
  
  RESULTS
  IBP was diagnosed in approximately half of the patients (89 patients) and 72 of them met the referral criteria. A total of 117 patients were finally referred to a rheumatologist and axial SpA was diagnosed for 37 of them.
  
  
  CONCLUSIONS
  The high prevalence of undiagnosed axial SpA in patients with chronic back pain visiting PMR physicians, orthopedists, and ophthalmologists suggests that these healthcare professionals may play a key role in the strategy developed to shorten the delay observed in the formal diagnosis of SpA.
  
  
  BACKGROUND
  Abbvie.
authors.affiliation: Rheumatology and Physical Medicine Department, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Laure
authors.initials: L
authors.lastname: Tant
authors.affiliation: AbbVie, Wavre, Belgium. nadine.delmotte@abbvie.com.
authors.forename: Nadine
authors.initials: N
authors.lastname: Delmotte
authors.affiliation: AbbVie, Wavre, Belgium. maria.vandenenden@abbvie.com.
authors.forename: Maria
authors.identifier: http://orcid.org/0000-0003-3723-6300
authors.initials: M
authors.lastname: Van den Enden
authors.affiliation: Rheumatology and Physical Medicine Department, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Valerie
authors.initials: V
authors.lastname: Gangji
authors.affiliation: Rheumatology Department, University Hospital, Ghent, Belgium.
authors.forename: Herman
authors.initials: H
authors.lastname: Mielants
keywords: ASAS criteria; Inflammatory back pain; Ophthalmologist; Orthopedists; Physical medicine and rehabilitation physician; Referral