The assessment of disease impact for rheumatological conditions is a challenging topic of relevant interest in the last years. Severity is closely related to disease impact, and related to several aspects of clinical conditions, including, among others, disease activity, physical function, and damage. All these are closely interrelated with the term “quality of life,” reflecting the impact that the disease may have on the patient. The field of spondyloarthritis (SpA) has not been unaware of these concepts, and efforts have been made to develop instruments assessing domains going beyond physical function, disease activity, and pain. Axial SpA (axSpA) is characterized by inflammation and new bone formation affecting the axial skeleton and joints. These patients may have symptoms related not only to chronic back pain but also to spinal stiffness, peripheral manifestations, and extramusculoskeletal features. The disease course is characterized by functional disability and limitation in activities and social participation. The influence of the disease on health-related quality of life has been characterized and does not differ in terms of health status, disease activity, and physical function between radiographic and nonradiographic axSpA.
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