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Spondyloarthropathy is any joint disease of the vertebral column.^[1] 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. However, many conditions involve both spondylopathy and spondyloarthropathy.

Spondyloarthropathy with inflammation is called spondylarthritis. 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, the group often being termed specifically 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.

Nonvertebral symptoms of spondyloarthropathies include asymmetric peripheral arthritis (which is distinct from rheumatoid arthritis), arthritis of the Toe IP Joints, sausage digits, achilles tenosynovitis, plantar fasciitis, costochondritis, iritis, and mucocutaneous lesions. However, lower back pain is the most common clinical presentation of the disease; this back pain is unique because it decreases with activity.

Seronegative spondyloarthropathy[edit]

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 what is commonly seen in rheumatoid arthritis.

Conditions[edit]

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

Condition	Percent of people with the condition who are HLA-B27 positive
Ankylosing Spondylitis^[4]^[5]	Caucasians: 92%^[6] African-Americans:50%
Reactive arthritis^[4]^[5] (Reiter's syndrome)	60-80%
enteropathic spondylitis or spondylitis associated with inflammatory bowel disease^[4]^[5] (including Crohn's disease and ulcerative colitis)	60%
Psoriatic arthritis^[4]^[5]	60%
Isolated acute anterior uveitis	50%
Undifferentiated spondyloarthropathy^[4]^[5] (USpA)	20-25%

Some sources also include Behcet's disease^{[citation needed]} and Whipple's disease.^[7]

Common characteristics[edit]

These diseases have the following conditions in common:

They are in relation to HLA-B27^[8]
Inflammatory arthritis, generally sacroiliitis and spondylitis^[5]
Oligoarthritis, generally with asymmetrical presentation^[5]
Enthesitis^[5] (inflammation of the entheses, the sites where tendons or ligaments insert into the bone.^[9]^[10])
familial aggregation occurs^[5]
rheumatoid factor is not present^[5]
Extra-articular features, such as involvement of eyes, skin and genitourinary tract^[5]
Overlap is likely between several of the causative conditions

References[edit]

^ thefreedictionary.com/spondyloarthropathy citing:
- Mosby's Medical Dictionary, 8th edition. © 2009
- Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003
- Saunders Comprehensive Veterinary Dictionary, 3 ed. © 2007
^ Howe HS, Zhao L, Song YW, et al. (February 2007). "Seronegative spondyloarthropathy--studies from the Asia Pacific region". Ann. Acad. Med. Singap. 36 (2): 135–41. PMID 17364081.
^ "Seronegative Spondyloarthropathies: Joint Disorders: Merck Manual Professional". Retrieved 2008-12-15.
^ ^a ^b ^c ^d ^e Luong AA, Salonen DC (August 2000). "Imaging of the seronegative spondyloarthropathies". Curr Rheumatol Rep 2 (4): 288–96. doi:10.1007/s11926-000-0065-z. PMID 11123073.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k Elizabeth D Agabegi; Agabegi, Steven S. (2008). Step-Up to Medicine (Step-Up Series). Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-7153-6.
^ Ankylosing Spondylitis and Undifferentiated Spondyloarthropathy Workup Author: Lawrence H Brent. Chief Editor: Herbert S Diamond. Updated: Apr 19, 2011
^ Várvölgyi C, Bubán T, Szakáll S, et al. (April 2002). "Fever of unknown origin with seronegative spondyloarthropathy: an atypical manifestation of Whipple's disease". Ann. Rheum. Dis. 61 (4): 377–8. doi:10.1136/ard.61.4.377. PMC 1754069. PMID 11874851.
^ Shankarkumar U, Devraj JP, Ghosh K, Mohanty D (2002). "Seronegative spondarthritis and human leucocyte antigen association". Br. J. Biomed. Sci. 59 (1): 38–41. PMID 12000185.
^ Maria Antonietta D'Agostino, MD, Ignazio Olivieri, MD. (June 2006). Enthesitis 20 (3). Clinical Rheumatology. pp. 473–486. doi:10.1016/j.berh.2006.03.007. |accessdate= requires |url= (help)
^ The Free Dictionary (2009). "Enthesitis". Retrieved 2010-11-27.

External links[edit]

http://www.gpnotebook.co.uk/simplepage.cfm?ID=-254803955
Information from the American College of Rheumatology
Spondyloarthropathies: Update on Diagnosis and Treatment from ConsultantLive.

UpToDate Contents

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1. X線所見が認められない軸性脊椎関節炎、未分化型脊椎関節炎、および末梢性脊椎関節炎 non radiographic axial spondyloarthritis undifferentiated spondyloarthritis and peripheral spondyloarthritis
2. 成人における強直性脊椎炎およびX線所見による変化が認められない軸性脊椎関節炎の診断および鑑別診断 diagnosis and differential diagnosis of ankylosing spondylitis and non radiographic axial spondyloarthritis in adults
3. 脊椎関節炎の病因 pathogenesis of spondyloarthritis
4. 成人における強直性脊椎炎の評価および治療 assessment and treatment of ankylosing spondylitis in adults
5. 反応性関節炎 reactive arthritis

English Journal

Defining an optimal referral strategy for patients with a suspicion of axial spondyloarthritis: what is really important? Response to: 'Evaluating the ASAS recommendations for early referral of axial spondyloarthritis in patients with chronic low back pain; is one parameter present sufficient for primary care practice?' by van Hoeven et al.

Poddubnyy D1, van Tubergen A2, Landewé R3, Sieper J1, van der Heijde D4.
Annals of the rheumatic diseases.Ann Rheum Dis.2015 Dec;74(12):1. doi: 10.1136/annrheumdis-2015-208553. Epub 2015 Oct 19.
PMID 26483254

Evaluating the ASAS recommendations for early referral of axial spondyloarthritis in patients with chronic low back pain; is one parameter present sufficient for primary care practice?

van Hoeven L1, Koes BW2, Hazes JM3, Weel AE1.
Annals of the rheumatic diseases.Ann Rheum Dis.2015 Dec;74(12):e68. doi: 10.1136/annrheumdis-2015-208547. Epub 2015 Sep 28.
PMID 26416898

Erratum to: Single nucleotide polymorphism of toll-like receptor 4 (TLR4) is associated with juvenile spondyloarthritis in Croatian population.

Perica M1, Vidović M2, Lamot L3,4, Tambić Bukovac L5, Kapitanović S6, Perić M7, Barbić J8,9, Harjaček M10,11.
Clinical rheumatology.Clin Rheumatol.2015 Dec;34(12):2087.
PMID 26412235

Japanese Journal

Cutaneous polyarteritis nodosa associated with HLA-B39-positive undifferentiated spondyloarthritis in a Japanese patient

NAKANO Hiromasa,OOKA Seido,SHIBATA Tomohiko,OGAWA Hitoshi,ITO Hiroshi,TAKAKUWA Yukiko,TONOOKA Kumiko,MAEDA Akihiko,YAMASAKI Yoshioki,KIYOKAWA Tomofumi,NAGAFUCHI Hiroko,YAMADA Hidehiro,OZAKI Shoichi
Modern rheumatology 22(5), 783-786, 2012-09-01
NAID 10031028056