{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T06:17:57Z","timestamp":1792563477274,"version":"4.5.0"},"reference-count":41,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T00:00:00Z","timestamp":1693958400000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011110","name":"UCB","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011110","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Best Practice & Research Clinical Rheumatology"],"published-print":{"date-parts":[[2023,9]]},"DOI":"10.1016\/j.berh.2023.101871","type":"journal-article","created":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T23:18:54Z","timestamp":1694647134000},"page":"101871","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":31,"title":["Challenges in the diagnosis of axial spondyloarthritis"],"prefix":"10.1016","volume":"37","author":[{"given":"Floris A.","family":"van Gaalen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Rudwaleit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"1","key":"10.1016\/j.berh.2023.101871_bib1","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2021-002067","article-title":"Current differentiation between radiographic and non-radiographic axial spondyloarthritis is of limited benefit for prediction of important clinical outcomes: data from a large, prospective, observational cohort","volume":"8","author":"Ciurea","year":"2022","journal-title":"RMD Open"},{"issue":"1","key":"10.1016\/j.berh.2023.101871_bib2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1136\/ard-2022-223296","article-title":"ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update","volume":"82","author":"Ramiro","year":"2023","journal-title":"Ann Rheum Dis"},{"issue":"3","key":"10.1016\/j.berh.2023.101871_bib3","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0230268","article-title":"Spinal radiographic progression in axial spondyloarthritis and the impact of classification as nonradiographic versus radiographic disease: data from the Swiss Clinical Quality Management cohort","volume":"15","author":"Hebeisen","year":"2020","journal-title":"PLoS One"},{"issue":"3","key":"10.1016\/j.berh.2023.101871_bib4","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.rdc.2012.08.002","article-title":"Classification, diagnosis, and referral of patients with axial spondyloarthritis","volume":"38","author":"Braun","year":"2012","journal-title":"Rheum Dis Clin N Am"},{"issue":"2","key":"10.1016\/j.berh.2023.101871_bib5","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s00296-002-0237-4","article-title":"Age at disease onset and diagnosis delay in HLA-B27 negative vs. positive patients with ankylosing spondylitis","volume":"23","author":"Feldtkeller","year":"2003","journal-title":"Rheumatol Int"},{"issue":"4","key":"10.1016\/j.berh.2023.101871_bib6","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1097\/00002281-200107000-00006","article-title":"Ankylosing spondylitis and undifferentiated spondyloarthropathies: a clinical review and description of a disease subset with older age at onset","volume":"13","author":"Olivieri","year":"2001","journal-title":"Curr Opin Rheumatol"},{"issue":"3","key":"10.1016\/j.berh.2023.101871_bib7","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1002\/art.1780270301","article-title":"The risk of developing ankylosing spondylitis in HLA-B27 positive individuals. A comparison of relatives of spondylitis patients with the general population","volume":"27","author":"van der Linden","year":"1984","journal-title":"Arthritis Rheum"},{"issue":"4","key":"10.1016\/j.berh.2023.101871_bib8","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1093\/rheumatology\/keab544","article-title":"Age at onset in axial spondyloarthritis around the world: data from the Assessment in SpondyloArthritis international Society Peripheral Involvement in Spondyloarthritis study","volume":"61","author":"Boel","year":"2022","journal-title":"Rheumatology"},{"issue":"6","key":"10.1016\/j.berh.2023.101871_bib9","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1136\/ard.2008.101501","article-title":"New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS)","volume":"68","author":"Sieper","year":"2009","journal-title":"Ann Rheum Dis"},{"issue":"2","key":"10.1016\/j.berh.2023.101871_bib10","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2018-000825","article-title":"Diagnostic accuracy of inflammatory back pain for axial spondyloarthritis in rheumatological care","volume":"4","author":"Poddubnyy","year":"2018","journal-title":"RMD Open"},{"issue":"11","key":"10.1016\/j.berh.2023.101871_bib11","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1136\/annrheumdis-2019-215742","article-title":"Low specificity but high sensitivity of inflammatory back pain criteria in rheumatology settings in Europe: confirmation of findings from a German cohort study","volume":"78","author":"de Hooge","year":"2019","journal-title":"Ann Rheum Dis"},{"issue":"11","key":"10.1016\/j.berh.2023.101871_bib12","doi-asserted-by":"crossref","first-page":"1990","DOI":"10.1136\/annrheumdis-2014-205358","article-title":"A\u00a0novel evidence-based detection of undiagnosed spondyloarthritis in patients presenting with acute anterior uveitis: the DUET (Dublin Uveitis Evaluation Tool)","volume":"74","author":"Haroon","year":"2015","journal-title":"Ann Rheum Dis"},{"issue":"6","key":"10.1016\/j.berh.2023.101871_bib13","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1136\/annrheumdis-2013-204953","article-title":"Reference intervals of spinal mobility measures in normal individuals: the MOBILITY study","volume":"74","author":"Ramiro","year":"2015","journal-title":"Ann Rheum Dis"},{"issue":"12","key":"10.1016\/j.berh.2023.101871_bib14","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.3899\/jrheum.170786","article-title":"Frequency of impaired spinal mobility in patients with chronic back pain compared to patients with early axial spondyloarthritis","volume":"45","author":"Fongen","year":"2018","journal-title":"J\u00a0Rheumatol"},{"issue":"3","key":"10.1016\/j.berh.2023.101871_bib15","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1002\/art.24483","article-title":"The early disease stage in axial spondylarthritis: results from the German Spondyloarthritis Inception Cohort","volume":"60","author":"Rudwaleit","year":"2009","journal-title":"Arthritis Rheum"},{"issue":"8","key":"10.1016\/j.berh.2023.101871_bib16","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1093\/rheumatology\/ket164","article-title":"Percentage of patients with spondyloarthritis in patients referred because of chronic back pain and performance of classification criteria: experience from the Spondyloarthritis Caught Early (SPACE) cohort","volume":"52","author":"van den Berg","year":"2013","journal-title":"Rheumatology"},{"issue":"4","key":"10.1016\/j.berh.2023.101871_bib17","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1097\/00002281-199507000-00001","article-title":"HLA-B27 and its subtypes in world populations","volume":"7","author":"Khan","year":"1995","journal-title":"Curr Opin Rheumatol"},{"issue":"6","key":"10.1016\/j.berh.2023.101871_bib18","first-page":"1101","article-title":"Spondyloarthropathies in circumpolar populations of Chukotka (Eskimos and Chukchi): epidemiology and clinical characteristics","volume":"21","author":"Erdesz","year":"1994","journal-title":"J\u00a0Rheumatol"},{"issue":"1","key":"10.1016\/j.berh.2023.101871_bib19","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2021-002174","article-title":"Geographical prevalence of family history in patients with axial spondyloarthritis and its association with HLA-B27 in the ASAS-PerSpA study","volume":"8","author":"Boel","year":"2022","journal-title":"RMD Open"},{"issue":"4","key":"10.1016\/j.berh.2023.101871_bib20","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1002\/art.1780270401","article-title":"Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria","volume":"27","author":"van der Linden","year":"1984","journal-title":"Arthritis Rheum"},{"issue":"4","key":"10.1016\/j.berh.2023.101871_bib21","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1097\/BOR.0000000000000066","article-title":"Assessment of sacroiliitis by radiographs and MRI: where are we now?","volume":"26","author":"van Gaalen","year":"2014","journal-title":"Curr Opin Rheumatol"},{"issue":"8","key":"10.1016\/j.berh.2023.101871_bib22","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1136\/ard.2010.145995","article-title":"Rates and predictors of radiographic sacroiliitis progression over 2 years in patients with axial spondyloarthritis","volume":"70","author":"Poddubnyy","year":"2011","journal-title":"Ann Rheum Dis"},{"issue":"11","key":"10.1016\/j.berh.2023.101871_bib23","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1136\/annrheumdis-2017-211596","article-title":"Sacroiliac radiographic progression in recent onset axial spondyloarthritis: the 5-year data of the DESIR cohort","volume":"76","author":"Dougados","year":"2017","journal-title":"Ann Rheum Dis"},{"issue":"6","key":"10.1016\/j.berh.2023.101871_bib24","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1136\/ard.62.6.519","article-title":"Radiographic assessment of sacroiliitis by radiologists and rheumatologists: does training improve quality?","volume":"62","author":"van Tubergen","year":"2003","journal-title":"Ann Rheum Dis"},{"issue":"4","key":"10.1016\/j.berh.2023.101871_bib25","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1093\/rheumatology\/keac432","article-title":"Comparing MRI and conventional radiography for the detection of structural changes indicative of axial spondyloarthritis in the ASAS cohort","volume":"62","author":"Protopopov","year":"2023","journal-title":"Rheumatology"},{"issue":"3","key":"10.1016\/j.berh.2023.101871_bib26","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1002\/art.40718","article-title":"Is it useful to repeat magnetic resonance imaging of the sacroiliac joints after three months or one year in the diagnosis of patients with chronic back pain and suspected axial spondyloarthritis?","volume":"71","author":"Bakker","year":"2019","journal-title":"Arthritis Rheumatol"},{"issue":"6","key":"10.1016\/j.berh.2023.101871_bib27","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1136\/annrheumdis-2013-203887","article-title":"Does spinal MRI add incremental diagnostic value to MRI of the sacroiliac joints alone in patients with non-radiographic axial spondyloarthritis?","volume":"74","author":"Weber","year":"2015","journal-title":"Ann Rheum Dis"},{"issue":"6","key":"10.1016\/j.berh.2023.101871_bib28","doi-asserted-by":"crossref","first-page":"e34","DOI":"10.1136\/annrheumdis-2017-212175","article-title":"Alternative diagnoses in patients with chronic back pain not diagnosed with axial spondyloarthritis: data from the SPACE cohort","volume":"77","author":"Ez-Zaitouni","year":"2018","journal-title":"Ann Rheum Dis"},{"issue":"6","key":"10.1016\/j.berh.2023.101871_bib29","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1136\/ard.2009.108233","article-title":"The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection","volume":"68","author":"Rudwaleit","year":"2009","journal-title":"Ann Rheum Dis"},{"issue":"7","key":"10.1016\/j.berh.2023.101871_bib30","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/acr.22583","article-title":"Distinctions between diagnostic and classification criteria?","volume":"67","author":"Aggarwal","year":"2015","journal-title":"Arthritis Care Res"},{"issue":"5","key":"10.1016\/j.berh.2023.101871_bib31","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1136\/annrheumdis-2016-210747","article-title":"Performance of the ASAS classification criteria for axial and peripheral spondyloarthritis: a systematic literature review and meta-analysis","volume":"76","author":"Sepriano","year":"2017","journal-title":"Ann Rheum Dis"},{"issue":"9","key":"10.1016\/j.berh.2023.101871_bib32","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1136\/ard.2005.051045","article-title":"Easy assessment of axial spondyloarthritis (early ankylosing spondylitis) at the bedside","volume":"65","author":"Rudwaleit","year":"2006","journal-title":"Ann Rheum Dis"},{"issue":"6","key":"10.1016\/j.berh.2023.101871_bib33","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1136\/annrheumdis-2016-210119","article-title":"Presence of multiple spondyloarthritis (SpA) features is important but not sufficient for a diagnosis of axial spondyloarthritis: data from the SPondyloArthritis Caught Early (SPACE) cohort","volume":"76","author":"Ez-Zaitouni","year":"2017","journal-title":"Ann Rheum Dis"},{"issue":"7","key":"10.1016\/j.berh.2023.101871_bib34","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1093\/rheumatology\/key035","article-title":"Imaging of the sacroiliac joints is important for diagnosing early axial spondyloarthritis but not all-decisive","volume":"57","author":"Ez-Zaitouni","year":"2018","journal-title":"Rheumatology"},{"issue":"10","key":"10.1016\/j.berh.2023.101871_bib35","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1136\/ard.2009.110767","article-title":"Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS\/OMERACT MRI group","volume":"68","author":"Rudwaleit","year":"2009","journal-title":"Ann Rheum Dis"},{"issue":"11","key":"10.1016\/j.berh.2023.101871_bib36","doi-asserted-by":"crossref","first-page":"1958","DOI":"10.1136\/annrheumdis-2015-208642","article-title":"Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group","volume":"75","author":"Lambert","year":"2016","journal-title":"Ann Rheum Dis"},{"issue":"7","key":"10.1016\/j.berh.2023.101871_bib37","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1002\/art.40475","article-title":"Magnetic resonance imaging of the sacroiliac joints indicating sacroiliitis according to the assessment of SpondyloArthritis international society definition in healthy individuals, runners, and women with postpartum back pain","volume":"70","author":"de Winter","year":"2018","journal-title":"Arthritis Rheumatol"},{"issue":"5","key":"10.1016\/j.berh.2023.101871_bib38","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1002\/art.40429","article-title":"Frequency and anatomic distribution of magnetic resonance imaging features in the sacroiliac joints of young athletes: exploring \"background noise\" toward a data-driven definition of sacroiliitis in early spondyloarthritis","volume":"70","author":"Weber","year":"2018","journal-title":"Arthritis Rheumatol"},{"key":"10.1016\/j.berh.2023.101871_bib39","series-title":"Can axial spondyloarthritis unequivocally be diagnosed by rheumatologists in patients with chronic back pain of less than two years duration? Main result of the SPondyloarthritis Caught Early (SPACE) cohort","first-page":"3","author":"Marques","year":"2023"},{"issue":"9","key":"10.1016\/j.berh.2023.101871_bib40","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1136\/annrheumdis-2020-219446","article-title":"Polygenic Risk Scores have high diagnostic capacity in ankylosing spondylitis","volume":"80","author":"Li","year":"2021","journal-title":"Ann Rheum Dis"},{"issue":"4","key":"10.1016\/j.berh.2023.101871_bib41","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/BOR.0000000000000871","article-title":"Novel imaging techniques for sacroiliac joint assessment","volume":"34","author":"Morb\u00e9e","year":"2022","journal-title":"Curr Opin Rheumatol"}],"container-title":["Best Practice & Research Clinical Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1521694223000578?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1521694223000578?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T17:24:35Z","timestamp":1761499475000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1521694223000578"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":41,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["S1521694223000578"],"URL":"https:\/\/doi.org\/10.1016\/j.berh.2023.101871","relation":{},"ISSN":["1521-6942"],"issn-type":[{"value":"1521-6942","type":"print"}],"subject":[],"published":{"date-parts":[[2023,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Challenges in the diagnosis of axial spondyloarthritis","name":"articletitle","label":"Article Title"},{"value":"Best Practice & Research Clinical Rheumatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.berh.2023.101871","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"101871"}}