TY - JOUR T1 - Spondyloarthritis Among Patients With Uveitis: Can We Improve Referral Pathways? JF - The Journal of Rheumatology JO - J Rheumatol SP - 659 LP - 660 DO - 10.3899/jrheum.220263 VL - 49 IS - 7 AU - Lihi Eder Y1 - 2022/07/01 UR - http://www.jrheum.org/content/49/7/659.abstract N2 - Delays in diagnosis remain a major gap in the care of patients with axial spondyloarthritis (axSpA). Despite efforts to improve awareness among family physicians and nonrheumatologist specialists, the average duration from onset of symptoms to diagnosis of axSpA is approximately 8 years,1 which is one of the longest in rheumatology. Such delays in diagnosis are associated with late initiation of therapy and worse disease outcomes. Acute anterior uveitis (AAU), the most common extraarticular manifestation in SpA, affects 50% of patients and has been associated with longer delays in diagnosis.2 For many patients, AAU is the first encounter with a medical specialist, offering a unique opportunity for an early referral to rheumatology. Thus, studying the association between these 2 conditions could inform the development of more effective referral pathways from ophthalmology to rheumatology, ultimately improving early diagnosis of axSpA.In this edition of The Journal of Rheumatology, van Bentum et al describe the effect of an initiative aimed to increase awareness and referrals to rheumatology of patients with AAU and chronic back pain (CBP) seen in academic and community ophthalmology centers in Amsterdam.3 The referral criteria comprised an accepted definition of CBP (back pain of ≥ 3 months’ duration that started prior to the age of 45 years) among patients with new or recurrent AAU. All patients were assessed by a rheumatologist for clinical signs and symptoms of axSpA. Additionally, radiographic assessment of the sacroiliac joints was performed and HLA-B27 status determined in all patients. Magnetic resonance imaging (MRI) of the spine was performed only if deemed clinically necessary for diagnostic purposes.Among patients with AAU and CBP, the study found a prevalence of 23% (19 out of 81 patients) for previously undiagnosed axSpA, which was almost … Address correspondence to Dr. L. Eder, 76 Grenville Street, Women’s College Hospital, Toronto, ON M5S 1B2, Canada. Email: Lihi.eder{at}wchospital.ca. ER -