Axial spondyloarthritis (axSpA) typically starts before the fourth decade oflife. Consistent with that, the Assessment of SpondyloArthritis international Society (ASAS)classification criteria for axSpA should be applied only in patients with chronic back pain startingbefore 45 years of age. It has, however, been suggested that axSpA can sometimes start later in lifewith a distinctive phenotype, the so-called ‘l...
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