SPACE study

The SPACE project stands for SPondyloArthritis Caught Early project. Patients visiting the outpatient clinic of the rheumatology department at the LUMC with short-term, chronic back pain (existing more than 3 months but less than 2 years) are asked by their rheumatologist to participate in the SPACE project.
Between the onset of symptoms and the diagnosis is often a long time. This leads to uncertainty by the patient and increased healthcare costs. In addition, early diagnosis of the disorder is important so appropriate treatment can be started faster. The goal of this project is the earlier diagnosis and treatment of spondyloarthritis (SpA).

 We try to identify signs and symptoms that could lead to an early recognition of SpA. We will also follow the course of the disease in detail, including the effects of any treatment given by the rheumatologist.
The role of MRI and radiographs in the diagnostic process is intensively investigated in this descriptive (observational) study. An MRI can show both the degree of inflammation and structural damage of the SI joints and/or spine, while on radiographs only structural damage as a consequence of chronic inflammation is visible. An MRI can thus detect in an earlier stage of the disease whether something is wrong. Taking into account the most typical characteristics of SpA on MRI, we try to shorten the diagnostic period. More information about the SPACE-project can be found on the website

Key publications:
1. van den Berg R, de Hooge M, van Gaalen F, Reijnierse M, Huizinga T, van der Heijde D. Percentage of patients with spondyloarthritis in patients referred because of chronic back pain and performance of classification criteria: experience from the SpondyloArthrits Caught Early (SPACE) cohort. Rheumatology published 6 May 2013, doi:10.1093/rheumatology/ket164
2. van den Berg R, de Hooge M, Rudwaleit M, Sieper J, van Gaalen F, Reijnierse M, Landewé R, Huizinga T, van der Heijde D. ASAS modification of the Berlin algorithm for diagnosing axial spondyloarthritis: results from the SPondyloArthritis Caught Early (SPACE)-cohort and from the Assessment of SpondyloArthritis international Society (ASAS)-cohort. Ann Rheum Dis 2013;72:1646-53
3. de Hooge M, van den Berg R, Navarro-Compán V, van Gaalen F, van der Heijde D, Huizinga T, Reijnierse M. Magnetic resonance imaging of the sacroiliac joints in the early detection of spondyloarthritis: No added value of gadolinium compared with short tau inversion recovery sequence. Rheumatology 2013;52:1220-4