JointHealth™ express   July 13, 2021

Axial spondylitis is a type of inflammatory arthritis that affects roughly 300,000 Canadians. If left untreated, it can cause immense pain and lasting damage to the spine.

In a ground-breaking report, the Axial Spondyloarthritis International Federation (ASIF) looks at key diagnosis challenges across different healthcare systems to better understand how the delays affect individuals and to identify opportunities for addressing these. ASIF’s Delay to Diagnosis Report is based on a full literature review, and two global forum events, involving more than 90 patients and patient group representatives, researchers, rheumatologists, and other healthcare professionals from 23 countries.

The report identifies that an average 7-year delay to diagnosis of axial spondyloarthritis (axSpA) can leave young patients with irreversible damage to their spine and a devastating effect on their mental health.

The report also highlights gender inequality in diagnosis, with women waiting longer than men, and stresses the limited progress in reducing the time to diagnosis. With onset typically in a patient’s 20’s, the delay can have a devastating impact on their quality of life at a critical time.

Zhivko Yanko, Chair of ASIF commented, “While their peers are forging careers, developing relationships and making choices that will guide their future, these undiagnosed patients are suffering debilitating back pain, potentially leading to irreversible fusing of the spine, as well as often many other seemingly unrelated conditions such as uveitis and psoriasis. Compounded and unexplained, too frequently, this significantly impacts their mental health.”

The report’s five recommendations identify steps that need to be taken to reduce the delay – and transform lives. The report recognises six global commonalities across different countries and healthcare systems, which contribute to the almost average 7-year delay to diagnosis. These include:
  1. poor awareness of axSpA amongst those with symptoms;
  2. lack of disease recognition amongst the wider population;
  3. incorrect diagnosis at the first point of healthcare system contact;
  4. poorly defined referral pathways;
  5. difficulties in accessing appropriate care; and,
  6. challenges within rheumatology itself.
Telling their real-life stories, three axSpA patients share the impact the delay to diagnosis had on their lives in three short and powerful videos available on the ASIF website.

Read the report at

About axial spondyloarthritis (axSpA)

AxSpA is a chronic inflammatory disease that encompasses radiographic (Ankylosing Spondylitis or AS) and non-radiographic (nr-axSpA) forms. It is a rheumatic inflammatory disease primarily affecting the spine and sacroiliac joints. It can lead to chronic pain, structural damage and disability. More about axSpA:

Leading symptom: Inflammatory back pain that improves with exercise but not with rest
Disease onset: Usually before the age of 45, often in the 20’s
Prevalence: Similar to Rheumatoid Arthritis 0.2-1.4% of adults have axSpA
Comorbidities: Patients may also experience uveitis, psoriasis, enthesitis and IBD
axSpA: Affects both men and women equally