Evaluating the ASAS recommendations for early referral of axial spondyloarthritis in patients with chronic low back pain; is one parameter present sufficient for primary care practice?

New diagnostic tools and effective treatment for axial spondyloarthritis (axSpA) became available in the last decade. This has raised the need for adequate referral strategies for patients with low back pain suspected of axSpA. However, there is no agreement on which referral strategy is best. Recently, the Assessment of SpondyloArthritis international Society (ASAS) group has published recommendations for the early referral for suspected axSpA1 (box 1). Nonetheless, some critical remarks can be made regarding these recommendations. Box 1 ### The Assessment of SpondyloArthritis international Society (ASAS)-endorsed recommendations for early referral of patients suspected for having axial spondyloarthritis by primary care physicians or non-rheumatologists1