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In these videos, Devon Charlton, MD, rheumatologist at University of Pittsburgh Medical Center, and Delamo I. Bekele, MBBS, clinical rheumatologist and assistant professor of medicine at Mayo Clinic, discussed the diagnostic challenges across spondyloarthropathy conditions.

Charlton spoke about:

• The diagnostic process – “You’re ruling things out more than in;”
• A new decision tool for patients and physicians;
• Approaches to distinguishing one spondyloarthopathy from another;
• Unique challenges of early detection in a more rural setting where many people have labor-intensive occupations;
• Challenges of managing spondyloarthropathies, such as finding the right medication, educating patients on what to expect, being able to differentiate the pain patients are having between their comorbidities;
• Addressing the “big challenge” of delayed diagnosis and misdiagnosis seen across autoimmune diseases;
• Complications of misdiagnosis like “downstream damage, compounding of disease and new manifestations;”
• Advantages of early detection, such as avoiding damage, improving quality of life, helping comorbidities and possible neurologic benefits; and
• Future areas of research, such as finding a specific, diagnostic marker for different types of spondylarthritis.

Bekele spoke about:

• The diagnostic process for rheumatologists examining patients with possible spondyloarthropathies, including the importance of getting the patient’s history of back and joint complaints, doing a physical exam and when to consider genetic testing;
• Why a simple classification is “the best way to get to the diagnosis;”
• Challenges of early recognition;
• Addressing delayed diagnosis and misdiagnosis across spondyloarthopathy conditions;
• The need for education among non-rheumatologists who see patients with non-specific pain or joint complaints and the importance of referring to a rheumatologist “when in doubt;”
• The frequency of misdiagnosis by other healthcare professionals and resulting complications;
• Benefits of early diagnosis, such as better pain control, decreasing functional impairment and reducing the development of complications; and
• How future research can address diagnostic challenges.