Axial Spondyloarthritis: Overcoming the Barriers to Early Diagnosis—an Early Inflammatory Back Pain Service

Purpose of Review To discuss the challenges to early diagnosis of axial spondyloarthritis (axSpA) and present the impact an early inflammatory back pain service (EIBPS) had on diagnostic delay in the UK. Recent Findings Diagnostic delay in axSpA varies greatly worldwide, and has continued in the UK at an average of 8.5 years. Education, public awareness, and accessibility to inflammatory back pain (IBP) pathways are some of the key barriers to achieving a prompt diagnosis. A recent national inquiry has highlighted insufficiencies in the availability of specialist axSpA services and limited provision of education and training to first contact practitioners and allied healthcare providers. Summary We demonstrate diagnostic delay in axSpA can be successfully reduced to 3 years when an early inflammatory back pain service is embedded within a rheumatology department alongside a local educational and awareness campaign. Sharing these experiences and outcomes will enable other departments to engage in best practice and achieve similar results, facilitating a timely and accurate diagnosis.