Masterclass- Axial and peripheral Spondyloarthritis: Screening, suspicion and referral in musculoskeletal clinical practice.

INTRODUCTION

Spondyloarthritis is an umbrella term for a group of inflammatory diseases that can present as back pain, joint pain and swelling, or tendon problems. Although as common as rheumatoid arthritis, awareness and screening questioning for axial and peripheral spondyloarthritis in musculoskeletal clinical practice is not yet core clinical practice and likely to be contributing to delays in diagnosis.

PURPOSE: The masterclass aims to increase awareness of the clinical features and risk factors that raise suspicion that persistent back, joint or tendon problems may be axial or peripheral spondyloarthritis. Guidance is provided on the updated inflammatory screening questioning important within musculoskeletal assessments, and for developing clinical knowledge and skills to support assessment for spondylarthritis, suspicion and referral to rheumatology. Clinical assessments need to question and examine for signs, symptoms and risk factors for both axial and peripheral spondyloarthritis. This involves screening for clinical features of inflammatory back pain, enthesitis, dactylitis, joint pain and swelling; prolonged morning stiffness; risk factors of psoriasis or family history of psoriasis, inflammatory bowel disease (IBD) -Crohn's disease and ulcerative colitis, uveitis, and family history of inflammatory arthritis. Referral criteria support clinical reasoning on levels of suspicion and when to refer to rheumatology.

IMPLICATIONS: Spondyloarthritis has been under-recognised in musculoskeletal assessments, which can have significant consequences for disease progression, complications and quality of life. Musculoskeletal clinicians play a crucial role in screening and supporting early recognition and intervention, which can significantly improve outcomes and reduce the impact of spondyloarthritis.