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Table 1 The CaFaspA referral strategy

From: Study protocol for a cluster randomized controlled trial to evaluate a referral strategy for axial spondyloarthritis in young primary care patients with chronic low back pain; an impact study

Applicable in patients ≥3 months back pain and age at oneset <45 years
Inflammatory back pain
Inflammatory back pain is considered present if at least four questions are answered with yes
 -Age at onset<40 years
 -Insidious onset
 -Improvement with exercise
 -No improvement with rest
 -Pain at night (with improvement upon getting up)
Positive family history
A positive family history is considered present if there is a first or second degree family member with axial spondyloarthritis, Crohn’s disease, psoriasis or uveitis anterior
Good reaction to NSAIDs
A good reaction to NSAIDs is present when a patient reports a relieve in pain perception within 48 hours after receiving a NSAID
CLBP ≥5 years
A long low back duration is present if the duration of the back pain is 5 years or longer
If at least two out of the four referral parameters are present → a referral to the rheumatologist is advised