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Inflammatory back pain 

Inflammatory back pain
Inflammatory back pain
Axial Spondyloarthritis (Oxford Rheumatology Library)

Stefan Siebert

, Sengupta Raj

, and Alexander Tsoukas


Inflammatory back pain (IBP) refers to a collection of symptoms that may help identify patients with possible inflammatory spinal disease. A number of criteria sets have been proposed for IBP, which share common features such as: onset of symptoms aged <40 years, alternating buttock pain, improvement with exercise, worsening with rest, gradual onset, early morning stiffness, and improvement with NSAIDs. The IBP criteria were initially developed and validated in patients with ankylosing spondylitis, but have subsequently been shown to perform similarly in patients with axial spondyloarthritis (axSpA). The Berlin criteria demonstrated the highest specificity (84%) and the Calin criteria the highest sensitivity (92%). IBP criteria have been used in primary and secondary care referral strategies to facilitate the identification of patients with potential axSpA. It is important to note that IBP does not equate to a diagnosis of axSpA and many patients with IBP will not have axSpA.

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