Spondyloarthropathy

Spondyloarthropathy

Psoriatic arthritis of the spine

Spondyloarthropathy or spondyloarthrosis refers to a group of joint diseases that primarily affect the vertebral column. These conditions are characterized by inflammation and can lead to significant pain and disability. They encompass a range of disorders, including but not limited to psoriatic arthritis, Ankylosing spondylitis, and forms of rheumatoid arthritis.

Related terms

• spondylopathy is a disease of the vertebra
• Spondyloarthropathy with inflammation is called axial spondyloarthritis

Signs and symptoms

Non-vertebral signs and symptoms is back pain which is unique because it decreases with activity.

Seronegative spondyloarthropathy

Seronegative spondyloarthropathy (or seronegative spondyloarthritis) is a group of diseases involving the axial skeleton

"Seronegative" refers to the fact that these diseases are negative for rheumatoid factor

Types of Spondyloarthropathy

Spondyloarthropathies can be classified into several main types, each with distinct characteristics:

• Ankylosing Spondylitis: A chronic inflammatory disease that primarily affects the spine and sacroiliac joints.
• Psoriatic Arthritis: Associated with the skin condition psoriasis, this type can affect the spine in addition to other joints.
• Enteropathic Arthritis: Arthritis that is associated with inflammatory bowel diseases like Crohn's disease and ulcerative colitis.
• Reactive Arthritis: Arthritis that occurs as a reaction to an infection elsewhere in the body.

Symptoms

Common symptoms of spondyloarthropathies include:

• Chronic back pain and stiffness, often worse in the morning or after periods of inactivity.
• Pain and swelling in other joints, depending on the specific type.
• In severe cases, a reduction in spinal flexibility and overall mobility.

Diagnosis

Diagnosis of spondyloarthropathy involves:

• Clinical evaluation of symptoms.
• Imaging tests such as X-rays, MRI, and CT scans to detect changes in joints and bones.
• Blood tests to identify markers of inflammation and genetic markers associated with specific types.

Treatment

Treatment for spondyloarthropathies aims to manage symptoms and prevent or slow disease progression. Options include:

• Medications: Including nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologics.
• Physical Therapy: To maintain joint flexibility and muscle strength.
• Lifestyle Modifications: Such as regular exercise and maintaining a healthy weight.

Conditions

The following conditions are typically included within the group of seronegative spondylarthropathies:

Condition	Percent of people with the condition who are HLA-B27 positive
Axial spondyloarthritis (including ankylosing spondylitis)<ref name="pmid11123073">, Imaging of the seronegative spondyloarthropathies, Curr Rheumatol Rep, Vol. 2(Issue: 4), pp. 288–96, DOI: 10.1007/s11926-000-0065-z, PMID: 11123073,</ref><ref name=agabegi2nd257>, Step-Up to Medicine (Step-Up Series). online version, Hagerstwon, MD:Lippincott Williams & Wilkins, 2008, ISBN 978-0-7817-7153-5,</ref>	Caucasians: 92%<ref>Ankylosing Spondylitis and Undifferentiated Spondyloarthropathy Workup Author: Lawrence H Brent. Chief Editor: Herbert S Diamond. Updated: Apr 19, 2011</ref> African-Americans: 50%
Reactive arthritis<ref name="pmid11123073"/><ref name=agabegi2nd257/> (formerly known as Reiter's syndrome)	60–80%
Enteropathic arthropathy or spondylitis associated with inflammatory bowel disease<ref name="pmid11123073"/><ref name=agabegi2nd257/> (including Crohn's disease and ulcerative colitis)	60%
Psoriatic arthritis<ref name="pmid11123073"/><ref name=agabegi2nd257/>	40–50%
Isolated acute anterior uveitis	50%
Juvenile idiopathic arthritis (subtype: late-onset oligoarticular JIA)
Undifferentiated spondyloarthropathy<ref name="pmid11123073"/><ref name=agabegi2nd257/> (USpA)	20–25%

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Prognosis

The prognosis for individuals with spondyloarthropathy varies depending on the type and severity of the condition. Early diagnosis and treatment are key to managing symptoms and maintaining quality of life.