Spondyloarthritis is a group of diseases characterized by inflammation in the spine (“spondylitis”) and joints (“arthritis”).
Types of spondyloarthritis include:
Ankylosing spondylitis is a variant of spondyloarthritis that affects young adults. In ankylosing spondylitis, inflammation in the spine and sacroiliac joints causes chronic pain and stiffness in the back. Spondyloarthritis patients predominantly have disease in peripheral joints and frequently have inflammation at the attachment sites of tendons and ligaments to bones. Inflammation of whole fingers and toes is common, giving rise to a characteristic sausage-like appearance.
Psoriatic arthritis is another variant of spondyloarthritis. In psoriatic arthritis, psoriasis of the skin is paired with musculoskeletal features of spondyloarthritis, typically affecting peripheral joints. Eye inflammation (uveitis) is common in patients with ankylosing spondylitis or psoriatic arthritis.
It is thought that spondyloarthritis develops through to the interaction of genetic and environmental factors. Many patients with spondyloarthritis are positive for HLA-B27, a gene variant that controls immune responses. However, no single gene determines whether a person will develop spondyloarthritis. Many other genetic variants have been identified that increase disease risk. Reactive arthritis is a type of spondyloarthritis that develops after a urinary tract infection or an episode of infectious diarrhea caused by certain types of bacteria. It has been hypothesized that bacteria also play a role in ankylosing spondylitis and other variants of spondyloarthritis, typically without causing overt infection. Patients with inflammatory bowel (Crohn’s disease or ulcerative colitis) disease may develop spondyloarthritis suggesting that certain disease mechanisms are shared. Currently, we do not understand enough about the causes of spondyloarthritis to be able to prevent the disease.
Symptoms of spondyloarthritis vary between patients but may include:
Many patients with spondyloarthritis have a first degree relative with spondyloarthritis or spondyloarthritis-related disease (ankylosing spondylitis, psoriatic arthritis, psoriasis, Crohn’s disease, ulcerative colitis, uveitis).
Your doctor typically will begin by going through your medical history and conducting a thorough physical exam. Tests and procedures that may be used for diagnosing spondyloarthritis include:
The treatment for spondyloarthritis depends on the type of spondyloarthritis and severity of the illness. Treatment options include the following medications:
To learn more about our services or to make an appointment with a Brigham and Women’s Hospital rheumatologist, contact one of our trained coordinators at 1-800-294-9999 to get connected with the best doctor for your needs.
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