Early Identification and Diagnosis of Axial Spondyloarthritis

Overview

Axial spondyloarthritis (axSpA) is a chronic inflammatory condition that primarily affects the spine and sacroiliac joints. Early signs frequently present as persistent inflammatory back pain, often before age 45, and may include morning stiffness, buttock pain, and extra-musculoskeletal symptoms such as uveitis, psoriasis, or inflammatory bowel disease. Delayed diagnosis is common and contributes to prolonged pain, reduced quality of life, and increased healthcare burden.

In this evidence-based course, Dr. Dax G. Rumsey, MD, MSc, FRCP(C), guides physiotherapists and other non-rheumatology clinicians through the key elements of early axSpA recognition, assessment, and referral. You will learn how to distinguish inflammatory back pain from mechanical causes, apply clinical features and diagnostic criteria, and facilitate appropriate rheumatology referral — improving patient outcomes and reducing diagnostic delays.

What You Will Learn

Upon completion, participants will be able to:

1. Recognize inflammatory back pain patterns and differentiate them from mechanical back pain.

2. Identify clinical features of axial spondyloarthritis, including extra-spinal manifestations such as enthesitis and uveitis.

3. Understand epidemiology and disease progression of axSpA and non-radiographic axSpA.

4. Apply appropriate screening and referral criteria to support early diagnosis and rheumatology consultation.

5. Improve patient outcomes by facilitating timely intervention and interdisciplinary care.

Who Should Take This Course

This course is ideal for:

• Physiotherapists

• Primary care clinicians

• Chiropractors

• Musculoskeletal specialists managing chronic back pain

• Allied health professionals seeking improved competency in axSpA assessment

Whether you’re a routine assessor of back-pain patients or expanding your skills in inflammatory musculoskeletal conditions, this course will enhance clinical confidence and patient care.

About the Presenter

Dr. Dax G. Rumsey, MD, MSc, FRCP(C)



A pediatric rheumatologist at the University of Alberta and Stollery Children’s Hospital, Dr. Rumsey leads research and education initiatives in juvenile spondyloarthritis and inflammatory spine conditions. As chair of the Early Identification and Diagnosis of Axial Spondyloarthritis (EIDA) program, he brings expert clinical insight tailored to frontline clinicians.

Why This Course Matters

Delayed referral remains a major barrier to timely diagnosis of axial spondyloarthritis (axSpA).

A recent international survey of 1,650 healthcare professionals across 10 medical specialties examined barriers to rheumatology referral for patients with possible axSpA. The findings highlighted significant gaps in awareness and clinical decision-making:

• Instead of considering axSpA, clinicians were more likely to order rheumatoid factor (RF) and anti-nuclear antibody (ANA) tests for patients with chronic back pain

• This occurred despite the low likelihood of rheumatoid arthritis or lupus presenting primarily as chronic back pain

• As a result, opportunities for early identification and referral were frequently missed

Importantly, the survey also revealed a strong demand for targeted education:

• 62.3% of respondents wanted to learn more about the clinical course of axSpA

• 58.8% wanted more education on clinical evaluation and recognition

• 50.3% identified that education on new and emerging treatments would be helpful.

These findings reinforce the critical role of physiotherapists and frontline musculoskeletal clinicians in recognizing inflammatory back pain patterns and facilitating appropriate rheumatology referral.