Rheumatology leads collaborative international research in axial spondyloarthritis

Teamwork across multiple NNUH departments – Rheumatology, Gastroenterology, Radiology – and the UEA has enabled the Rheumatology team to identify patients with undiagnosed axial spondyloarthritis (axSpA), an arthritis-associated disease.

The research has also been supported by the National Axial Spondyloarthritis Society, N&N Hospitals Charity and AbbVie.

The work has been led by Edwin Lim and Karl Gaffney, Consultant Rheumatologists.

“We have recently published two important studies which both show there are often tell-tale signs of axSpA in patients who present to gastroenterology with inflammatory bowel disease, such as Crohn’s disease and ulcerative colitis, which could be identified earlier using imaging,” said Karl.

“Our Trust is the clinical lead on a national campaign to reduce the time to diagnosis for patients with axSpA that aims to reduce the delay to diagnosis from around eight years to one year.  axSpA affects one in 100 young people in the UK and often leads to permanent joint damage and disability.

“As most patients are of working age, early identification of the condition will help patients to be more active and avoid disability,” added Karl.

“Our research shows that in patients with inflammatory bowel disease who experience chronic lower back pain for more than three months, should be referred to Rheumatology services to see if axSpA is the cause.

“Vigilance and collaborative working across hospital departments is the key to earlier diagnosis of this serious condition.”

The studies have revealed that at least one in 20 patients attending Inflammatory Bowel Disease clinics with chronic back pain have undiagnosed axSpA.  This condition can also show up on CT scans of the pelvis which have been carried out in relation to the investigation of inflammatory bowel disease.  Vigilance can potentially reduce this delay to diagnosis among IBD patients.

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