Diagnostic delay in axial spondylarthritis: A lost battle?

Rosemarie Barnett, Karl Gaffney, Raj Sengupta

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)


Diagnostic delay in axial spondylarthritis (axSpA) remains an unacceptable worldwide problem; with evidence suggesting significant detrimental impact both clinically on the individual, and economically on society. There is therefore, a need for global action across various healthcare professions that come into contact with patients living, and suffering, with undiagnosed axSpA. Recent estimates of the median diagnostic delay suggest that globally, individuals with axSpA wait between 2 and 6 years for a diagnosis – revealing a clear benchmark for improvement. This timespan presents a window of opportunity for earlier diagnosis and intervention, which will likely improve patient outcomes. This review describes the current diagnostic delay as estimated across countries and over time, before presenting evidence from published strategies that may be implemented to improve this delay across primary and secondary care, including for specialties treating extra-musculoskeletal manifestations of axSpA (ophthalmology, gastroenterology, dermatology). Ongoing campaigns tackling delayed diagnosis in axSpA are also highlighted.

Original languageEnglish
Article number101870
JournalBest Practice and Research: Clinical Rheumatology
Issue number3
Early online date30 Aug 2023
Publication statusPublished - Sep 2023


  • Axial spondyloarthritis
  • Diagnosis
  • Early referral
  • Healthcare professional education
  • Quality improvement

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