How Non-Radiographic Axial Spondyloarthritis (nr-axSpA) Is Diagnosed

Early diagnosis and treatment can significantly improve your quality of life.

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Non-radiographic axial spondyloarthritis (nr-axSpA), is a type of inflammatory arthritis that primarily affects the spine. It falls under the umbrella of spondyloarthritis, a category of arthritis diseases that affect the spine.

Chronic back pain is the hallmark symptom of nr-axSpA, but it’s a bit different than other types of back pain. The onset of pain is often gradual and occurs in people under 45 years of age, and the occurrence of the pain is often worse in the morning and better after exercise. People with nr-axSpA may experience pain and inflammation in other parts of their body as well. Learn more about the symptoms of nr-axSpA.

Tests That Diagnose nr-axSpA

The diagnostic process for nr-axSpA doesn’t stop at X-rays and symptom checks. To diagnose nr-axSpA, doctors will often look at a variety of other factors and conduct more tests, such as:

  • Medical history
  • Physical exam
  • Blood tests: There’s no one blood test that can diagnose nr-axSpA, but doctors may do a test to look for a certain gene called the HLA-B27 gene, which is found in many people with spondyloarthritis.
  • Imaging tests: This includes X-rays and MRIs (magnetic resonance imaging). The “nr” in nr-axSpA stands for “non-radiographic,” which means there’s no damage visible on X-rays.

For some people, it may take months or years for a doctor to be confident in a diagnosis of nr-axSpA. Once nr-axSpA is diagnosed, the goals of treatment are to relieve symptoms, maintain function, and prevent complications. Treatment can also help minimize the risk other conditions that are associated with nr-axSpA, such as psoriasis or inflammatory bowel disease (IBD).

The first line of treatment is often non-steroidal anti-inflammatory drugs (NSAIDs) and physical therapy. If that doesn’t work, other medicines, such as disease-modifying antirheumatic drugs (DMARDs) or biologics, may be prescribed. Learn more about how nr-axSpA is treated here.