Spondyloarthropathy or spondyloarthrosis refers to any
joint disease of the
vertebral column. As such, it is a class or category of diseases rather than a single, specific entity. It differs from
spondylopathy, which is a disease of the vertebra itself, but many conditions involve both spondylopathy and spondyloarthropathy.
Spondyloarthropathy with inflammation is called
axial spondyloarthritis. In the broadest sense, the term spondyloarthropathy includes joint involvement of vertebral column from any type of joint disease, including
rheumatoid arthritis
Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are inv ...
and
osteoarthritis
Osteoarthritis (OA) is a type of degenerative joint disease that results from breakdown of joint cartilage and underlying bone which affects 1 in 7 adults in the United States. It is believed to be the fourth leading cause of disability in the ...
, but the term is often used for a specific group of disorders with certain common features, which are often specifically termed seronegative spondylarthropathies. They have an increased incidence of
HLA-B27, as well as negative
rheumatoid factor and
ANA.
Enthesopathy
An enthesopathy refers to a disorder involving the attachment of a tendon or ligament to a bone. This site of attachment is known as the enthesis (pl. entheses).
If the condition is known to be inflammatory, it can more precisely be called an ...
is also sometimes present in association with seronegative .
Non-vertebral signs and symptoms of degenerative or other not directly infected inflammation, in the manner of spondyloarthropathies, include asymmetric
peripheral arthritis (which is distinct from rheumatoid arthritis), arthritis of the toe interphalangeal joints,
sausage digits
Dactylitis or sausage digit is inflammation of an entire digit (a finger or toe), and can be painful.
The word dactyl comes from the Greek word "daktylos" meaning "finger". In its medical term, it refers to both the fingers and the toes.
Associ ...
,
Achilles tendinitis,
plantar fasciitis,
costochondritis,
iritis, and
mucocutaneous lesions. But
lower back pain is the most common clinical presentation of the causes of spondyloarthropoathies; this back pain is unique because it decreases with activity.
Seronegative spondyloarthropathy
''Seronegative spondyloarthropathy'' (or ''seronegative spondyloarthritis'') is a group of diseases involving the
axial skeleton and having a negative
serostatus.
"Seronegative" refers to the fact that these diseases are negative for
rheumatoid factor, indicating a different pathophysiological mechanism of disease than is commonly seen in
rheumatoid arthritis
Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are inv ...
.
Conditions
The following conditions are typically included in the group of ''seronegative spondylarthropathies'':
Some sources also include
Behçet's disease and
Whipple's disease.
Common characteristics
These diseases have the following conditions in common:
* Seronegative (i.e.
rheumatoid factor is not present)
[
* They are in relation to HLA-B27][
* ]Oligoarthritis
Oligoarthritis (from Greek ''oligos'' - 'few') is defined as arthritis
Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, ...
, generally with asymmetrical presentation[
* Enthesitis][ ( inflammation of the entheses, the sites where tendons or ligaments insert into the bone.), e.g. Plantar fasciitis, Achilles tendinitis, costochondritis.
* ]Familial aggregation
Family aggregation, also known as familial aggregation, is the clustering of certain traits, behaviours, or disorders within a given family. Family aggregation may arise because of genetic or environmental similarities.Butcher, J., S. Mineka, and ...
occurs[
* Extra-articular features, such as involvement of eyes (anterior uveitis), skin, genitourinary tract,][ and aortic regurgitation
* Overlap is likely between several of the causative conditions
]
Classification
Assessment of Spondylarthritis International Society (ASAS criteria) is used for classification of axial spondyloarthritis (to be applied for patients with back pain greater than or equal to 3 months and age of onset less than 45 years).
Treatment
Many patients have more than one of the spondyloarthritis disease manifestations. Some immunosuppressive drugs have shown efficacy in more than one of the diseases, e.g. tumor necrosis factor (TNF) inhibitors. But some of the immunosuppressive drugs are particularly effective for a specific inflamed tissue and approved in only one or two of the disease entities,
Epidemiology
Worldwide prevalence of spondyloarthropathy is approximately 1.9%.
References
External links
{{DEFAULTSORT:Spondyloarthropathy
Arthritis
Musculoskeletal disorders