Patient’s Journey: Behind a normal X-ray is a person who may be suffering with nr-axSpA
Patients with nr-axSpA can suffer with substantial disease burden.37,52
Proactive diagnosis and treatment is key.
EMILY, age 29
Real Estate Agent
Not an actual patient. Models are for illustrative purposes only.
History
- Back stiffness in the morning that improves with exercise
- Some peripheral swelling in left knee
- Widespread pain
- Fatigue
Medications
- Naproxen
- Duloxetine
- Recently prescribed pregabalin
Workup and lab results
- ESR, iron, B12, TSH, T3, T4: normal
- RF, CCP antibody: negative
- X-RAYs: no SIJ damage
- CRP Elevated: 15.4 mg/L
- HLA-B27: positive
Extraspinal manifestations in nr-axSpA*
MICHELLE, age 34
Event Planner
Not an actual patient. Models are for illustrative purposes only.
History
- Back pain that wakes her up at night
- Enthesitis at the plantar fascia
- Fatigue
- HLA-B27 negative
- Moderately elevated CRP
- X-RAYs NEGATIVE with no definitive damage to SIJ or lumbar spine
Medications
- Methotrexate
- Meloxicam
- Local corticosteroid injections
Workup and lab results
- Visual nail exam, ESR, iron: normal
- Skin changes: none
- CRP elevated: 15.4 mg/L
- MRI: Bone marrow edema, presence of fatty lesions
- ASCA IgG: elevated
Extraspinal manifestations in nr-axSpA*
ASCA IgG: Saccharomyces cerevisiae antibodies; CCP: cyclic citrullinated peptide; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; HLA-B27+: human leukocyte antigen-B27 positive; IBD: inflammatory bowel disease; nr-axSpA: non-radiographic axial spondyloarthritis; RF: rheumatoid factor; SIJ; sacroiliac joint; SpA: spondyloarthritis; TSH, T3, T4: thyroid panel tests.