Abstract:
Background. Axial spondyloarthritis is a chronic inflammatory rheumatic disease
predominantly affecting the axial skeleton and is a high burden on patients and health
systems worldwide. Its prevalence ranges between 0.2 and 0.9%, and its diverse
presentations and diagnostic delays highlight its ongoing relevance.
Objective(s). To describe the main clinical symptoms and paraclinical markers of axial
spondyloarthritis, focusing on inflammation, pain features, and laboratory tests that aid in
diagnosis and treatment.
Materials and methods. Materials were collected from databases including Elsevier,
ResearchGate, ScienceDirect, PubMed, and Google Scholar. The review analyzed peerreviewed articles, clinical cohorts, and trials focusing on clinical and paraclinical features of
axial spondylarthritis. Emphasis was placed on HLA-B27 status and inflammatory markers.
Results. Literature revealed clinical features include inflammatory back pain in nearly all
patients, peripheral arthritis (~30%), enthesitis (~40%), dactylitis (~6%), anterior uveitis
(25–35%), psoriasis (~10%), and inflammatory bowel disease (4–6%). Paraclinically, HLAB27 positivity occurs in 70–90% of White patients. Acute phase reactants such as CRP and
ESR are elevated in 50–60% of radiographic and 30–40% of non-radiographic axSpA.
Physical exams often lack sensitivity, emphasizing the role of laboratory tests and clinical
evaluation. Progression from non-radiographic to radiographic axSpA occurs in 5–10% at 2
years and up to 30% at 10 years.
Conclusion(s). Axial spondyloarthritis presents with diverse clinical features and often
subtle paraclinical findings. Early suspicion, careful imaging, and laboratory tests are crucial
for prompt diagnosis. Interdisciplinary collaboration improves outcomes and can reduce
long-term disability and complications.
