Diagnosis of ankylosing spondylitis

Background: The pathogenesis and pathological progression of ankylosing spondylitis (AS) remain unclear. Owing to the absence of a gold standard for diagnosing AS, diagnostic delays are frequently encountered in clinical practice, exacerbating the disease burden. In the past 16 years, several diagnostic studies on AS have been published. This study aimed to summarize the developmental trends and frontier hotspots in AS diagnosis through a bibliometric review. Methods: Data were extracted from English publications on AS diagnosis from the Web of Science Core Collection (January 1, 2008–October 21, 2024). CiteSpace, VOSviewer, and the Biblioshiny R package were used to analyze the overview of the publication output, countries/regions, institutions, authors, sources, references, and keywords. Results: A total of 1205 articles from 396 journals across 65 countries were included. The highest annual output occurred in 2021 (n = 111, 9.21%), whereas 2015 had the highest average number of citations (n = 5.1). Clinical Rheumatology (n = 76, 6.31%) was the most influential journal. China (n = 244, 20.25%), Berlin Institute of Health (n = 116, 9.63%), and Sieper J (n = 28, 2.32%) ranked first in terms of country, institution, and author productivity, respectively. The top 3 reference clusters were “diagnostic criteria,” “therapeutics,” and “recommendations.” Burst detection identified 4 emerging post-2021 keywords: “children,” “cells,” “spondyloarthritis,” and “expression.” Conclusion: AS diagnosis research has evolved through a growth phase (2008–2021), followed by a transitional or reorientation phase (2022–2024). Magnetic resonance imaging, Mendelian randomization, and biomarkers are current hotspots; Mendelian randomization serves as an etiological adjunct with the potential to inform biomarker discovery, though its findings do not yet constitute diagnostic tools. The apparent slowdown in recent years largely reflects evolving terminology (AS vs radiographic axial spondyloarthritis) and bibliometric time-lag bias rather than true intellectual stagnation, alongside fragmented pathophysiological insights and a lack of specific clinical features.