Investigators have found that it may be common for patients with axial spondyloarthritis and psoriatic arthritis to visit multiple health-care providers before receiving a correct diagnosis, according to a report from Healio. They stressed that as a result, patients with these conditions often experience diagnostic and treatment delays, worsening symptoms, and a reduced quality of life for up to several years prior to the initiation of appropriate treatment.
The investigators revealed that because low back pain is prevalent among adult patients, physicians may misdiagnose the symptoms of axial spondyloarthritis as mechanical or nonspecific low back pain rather than inflammatory back pain. A lack of clear diagnostic criteria, reliable biomarkers, and epidemiology may all lead to misdiagnoses in this patient population. Similarly, patients with psoriatic arthritis may face uncertain epidemiological factors, inadequate symptom recognition, and inappropriate referrals. After undergoing ineffective treatments—which may increase the risk of complications and poor clinical outcomes—patients with axial spondyloarthritis and psoriatic arthritis may visit multiple health-care providers without receiving a correct diagnosis for an average of 2.6 to 6.7 years. Patients who identify as female, are younger in age, have lower levels of education, have atypical disease presentation, and lack extra-articular manifestations may be at greater risk of experiencing diagnostic delays for axial spondyloarthritis; whereas patients who visit a dermatologist for a psoriatic rash and have early peripheral joint presentations may be at greater risk of experiencing diagnostic delays for psoriatic arthritis. “Promotion and dissemination of models of care that effectively screen for [rheumatic diseases] can improve access to care and identify patients earlier to shorten time to diagnosis,” highlighted Laura Passalent, PT, Assistant Professor at the University of Toronto and an advanced practice physiotherapist at the Schroeder Arthritis Institute.