Differentiating nonradiographic axial spondyloarthritis from its mimics: a narrative review

Philip Mease, Atul Deodhar

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations


Background: Optimal treatment of nonradiographic axial spondyloarthritis depends on accurate and timely diagnosis of the underlying disease; however, patients present with common symptoms that, in the absence of radiographic changes, may confound diagnosis. Methods and findings: In this narrative review, a PubMed literature search was conducted through January 2021, with no date limits, to identify English-language publications discussing classification of nonradiographic axial spondyloarthritis, with an emphasis on clinical features and presentation, differential diagnoses, and mimics of disease. This review describes the epidemiology, clinical features, and burden of disease of nonradiographic axial spondyloarthritis as it relates to the overall axial spondyloarthritis spectrum and discusses mimics and differential diagnoses of nonradiographic axial spondyloarthritis that should be considered when evaluating patients with suspected nonradiographic axial spondyloarthritis in clinical practice. Conclusions: Recognition of clinical features of nonradiographic axial spondyloarthritis, along with an understanding of comorbid conditions such as fibromyalgia, allows for differentiation from its mimics. Appropriate diagnosis of nonradiographic axial spondyloarthritis is important for aggressive management of disease to reduce pain, avoid loss of function, and improve quality of life.

Original languageEnglish (US)
Article number240
JournalBMC musculoskeletal disorders
Issue number1
StatePublished - Dec 2022


  • Differential diagnosis
  • Management
  • Narrative review
  • Nonradiographic axial spondyloarthritis
  • Treatment

ASJC Scopus subject areas

  • Rheumatology
  • Orthopedics and Sports Medicine


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