Spondyloarthropathy, also known as spondyloarthritis, is a group of inflammatory rheumatic diseases that affect the spine and other joints. These conditions are characterized by inflammation in the joints, especially in the spine and where ligaments and tendons attach to bone. Common types include ankylosing spondylitis, reactive arthritis, psoriatic arthritis, and arthritis associated with inflammatory bowel disease.
Key characteristics of spondyloarthropathies:
Inflammatory nature:
These conditions involve inflammation, leading to pain, stiffness, and swelling.
Spinal involvement:
The spine is often affected, causing back pain and stiffness, which can progress to fusion in some cases.
Enthesitis:
Inflammation at the sites where ligaments and tendons attach to bone (entheses) is common.
Seronegative:
Unlike rheumatoid arthritis, spondyloarthropathies are usually not associated with positive rheumatoid factor in blood tests.
HLA-B27 association:
Many individuals with spondyloarthropathies have the HLA-B27 gene, which is a genetic risk factor.
Overlap in symptoms:
Symptoms can overlap between different types of spondyloarthropathy.
Chronic and progressive:
These conditions can be chronic and progressive, leading to long-term pain and reduced mobility.
Common types of spondyloarthropathy:
Ankylosing spondylitis (AS):
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Primarily affects the spine, causing inflammation and potentially leading to spinal fusion.
Reactive arthritis (ReA):
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Can develop after an infection, often in the gastrointestinal or genitourinary tract.
Psoriatic arthritis (PsA):
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Associated with psoriasis, a skin condition, and can affect joints and entheses.
Arthritis associated with inflammatory bowel disease (IBD):
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Can occur with Crohn’s disease or ulcerative colitis.
Symptoms:
Back pain and stiffness: Often worse in the morning and relieved by activity.
Joint pain and swelling: Can affect various joints, including those in the limbs.
Enthesitis: Pain and inflammation at the sites where tendons and ligaments attach to bone.
Eye inflammation (uveitis): Can occur in some individuals.
Fatigue: A common symptom.
Other symptoms: Skin rash (psoriasis), gastrointestinal problems, or eye inflammation.
Diagnosis and treatment:
Diagnosis involves a combination of medical history, physical examination, imaging (X-rays), and blood tests.
Treatment aims to manage pain, reduce inflammation, and improve function.
Treatment options include non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologic agents.