Вісник проблем біології і медицини, Випуск 4 (167)
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Документ Axial spondyloarthritis. Clinical definition and diagnostic approaches(Полтавський державний медичний університет, 2022-12-07) Zhdan, V. M.; Volchenko, H. V.; Babanina, M. Yu.; Tkachenko, M. V.; Kyrian, O. A.; Ждан, Вячеслав Миколайович; Волченко, Григорій Вілійович; Бабаніна, Марина Юріївна; Ткаченко, Максим Васильович; Кир'ян, Олена АнатоліївнаThe diagnosis of axial spondyloarthritis is quite difficult and often delayed. Therefore, the goal of our work was to provide doctors with diagnostic guidelines, which are summarized in modern literature, as well as a methodology for planning a diagnostic search. A timely diagnosis of axial spondyloarthritis, regardless of its subsequent clinical evolution, allows one to switch from symptomatic to specific basic treatment as early as possible. The combination of sacroiliitis, spondylitis, and generalized enthesitis in a patient with chronic back pain is highly suggestive of axial spondyloarthritis. A condition for timely diagnosis is the correct assessment of the inflammatory nature of back pain. Pain relief on the background of physical activity, aggravation at night, improvement after morning activation, indistinct onset, and age up to 40 years are considered. With a high probability, axial spondyloarthritis is diagnosed with long-term back pain of an inflammatory nature in young people in the presence of sacroiliitis or HLA-B27 positivity in combination with specific additional signs. It is essential that this diagnosis remains legitimate even in the absence of radiological changes. Any case of chronic back pain syndrome, especially in adolescence or early adulthood, in the presence of X-ray changes in the spine requires a differential diagnosis with axial spondyloarthritis. The separation of axial spondyloarthritis into an independent clinical form among the group of chronic inflammatory spondyloarthropathies is due to the evolution of the possibilities of modern early pathogenetically directed basic treatment, which often provides a dramatic improvement in the course of the disease and the functional state of patients, reduces the risks of exacerbation, hospitalization, and disability.