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.[1] In the broadest sense, the term spondyloarthropathy includes joint involvement of vertebral column from any type of joint disease, including
rheumatoid arthritis and
osteoarthritis, 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 is also sometimes present in association with seronegative spondarthritides[clarify].
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,
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.[citation needed]
Seronegative spondyloarthropathy
Seronegative spondyloarthropathy (or seronegative spondyloarthritis) is a group of diseases involving the
axial skeleton[2] and having a negative
serostatus.
"Seronegative" refers to the fact that these diseases are negative for
rheumatoid factor,[3] indicating a different pathophysiological mechanism of disease than is commonly seen in
rheumatoid arthritis.
Conditions
The following conditions are typically included in the group of seronegative spondylarthropathies:
Condition
Percent of people with the condition who are
HLA-B27 positive
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).[11] It is of two broad types:[12][13]
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,[14] so an interdisciplinary approach is required.
Epidemiology
Worldwide
prevalence of spondyloarthropathy is approximately 1.9%.[15]
^Rudwaleit, M; Landewe, R; van der Heijde, D; Listing, J; Brandt, J; Braun, J; Burgos-Vargas, R; Collantes-Estevez, E; Davis, J; Dijkmans, B; Dougados, M; Emery, P; van der Horst-Bruinsma, I E; Inman, R; Khan, M A; Leirisalo-Repo, M; van der Linden, S; Maksymowych, W P; Mielants, H; Olivieri, I; Sturrock, R; de Vlam, K; Sieper, J (17 March 2009). "The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part I): classification of paper patients by expert opinion including uncertainty appraisal". Annals of the Rheumatic Diseases. 68 (6): 770–776.
doi:
10.1136/ard.2009.108217.
PMID19297345.
S2CID34185040.