ASAS Imaging Recommendations for Suspected Spondyloarthritis Save

ASAS (Assessment of Spondyloarthritis International Society) has convened specialized task force to guide imaging request on patients with suspected/known axial spondyloarthritis (axSpA). 

The task force included 7 radiologists, 11 rheumatologists and a patient representative. Using the Delphi method, two rounds of surveys were conducted among ASAS members. They proposed six detailed recommendations for clinicians involved in requesting imaging for patients with suspected or known axSpA. By improving the precision and relevance of imaging requests, these guidelines should enhance the clinical impact of radiology reports, facilitate accurate diagnosis and consequently improve the management of patients with axSpA.

Recommendations for requesting imaging in suspected or confirmed axSpA

1. The referring physician should communicate important clinical information, including the patient’s age, sex and HLA-B27 status.   
2. Requests for imaging should include current or history of back pain, duration, localization and inflammatory features, or if present, a change in clinical symptoms.    
3. Inform the Radiologists of physically demanding activities or recent childbirth 
4. Radiologists should have access to the images of prior imaging studies for comparison 
5. The referral should include possible contraindications to certain imaging modalities or to contrast medium.    
6. The referring clinician should indicate the suspected clinical diagnosis or if SpA was previously diagnosed. Is the examination a request for primary diagnosis, disease activity or treatment response?