M45.A6

Clinical Causes: Genetic predisposition, especially the presence of HLA-B27 gene Immune system dysfunction leading to inflammation Environmental factors that may trigger immune responses Family history of spondyloarthritis or other autoimmune conditions

Key Symptoms: Chronic lower back pain that improves with activity but worsens with rest Morning stiffness lasting more than 30 minutes Pain and stiffness in the hips or buttocks Limited flexibility and reduced range of motion in the lumbar spine Discrete episodes of flare-ups where symptoms intensify Possible fatigue and general feeling of discomfort

Diagnosis Path: Diagnosing nr-axSpA involves a combination of clinical assessment, laboratory tests, and imaging studies. Since X-rays may not show definitive changes, more sensitive imaging techniques like MRI are often employed to detect early inflammation of the sacroiliac joints and lumbar spine. Blood tests for markers of inflammation, such as elevated C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR), can support the diagnosis. The assessment also includes ruling out other causes of back pain and evaluating for associated symptoms of spondyloarthritis.

Treatment Protocols: Management of non-radiographic axial spondyloarthritis focuses on alleviating symptoms, maintaining mobility, and reducing inflammation. Common approaches include: - Nonsteroidal anti-inflammatory drugs (NSAIDs) to decrease inflammation and pain - Physical therapy to improve posture, flexibility, and strength - Regular exercise programs tailored to individual capabilities - Biological therapies, such as TNF inhibitors or IL-17 inhibitors, in cases where symptoms are resistant to conventional treatment - Patient education on lifestyle modifications and activity adjustments - Monitoring for disease progression and associated complications While there is currently no cure for nr-axSpA, early diagnosis and appropriate management can help maintain quality of life and functional ability.