Spondyloarthritis is an inflammatory rheumatic disease affecting the spine, joints and entheses (which are sites of insertion of a ligament, tendon, or articular capsule into bone, for example the Archilles tendonitis, plantar fasciitis). It is a collective group of several related diseases: Ankylosing spondylitis, Psoriatic arthritis, Enteropathic arthritis, Reactive arthritis, and Undiff erentiated spondyloarthritis.
Ankylosing Spondylitis (AS)
Ankylosing Spondylitis is a long-term disease that affects the joints in the spine, pelvis and, often, the peripheral joints such as hips, knees, ankles and feet as well. The main problem is chronic inflammation that may eventually cause the spine to fuse together.
The condition usually starts with low back pain that is worse at night, in the morning, or after prolonged inactivity, and tends to improve with exercise. Limited expansion in the chest may occur as a result of inflammation of the joints between the ribs. As the disease progresses, any portion of the spine may be affected.
The disease affects more males than females although females can also be affected. It tends to begin between age 20 and 40. Risk factors include having an affected family member and male gender.
Psoriasis is a scaly rash that can affect any part of the body, but most frequently the elbows, knees and scalp. In about 5 – 10% of patients with psoriasis, arthritis may also occur, giving rise to psoriatic arthritis. Apart from involvement of the spine, pelvis and joints, psoriatic arthritis is often accompanied by changes in the finger nails and toe nails such as the appearance of small pits.
Enteropathic arthritis is a form of spondyloarthritis that is associated with inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis, which typically causes inflammation of the intestines. About 1 in 6 people with inflammatory bowel disease will develop enteropathic arthritis affecting the spine and joints.
Reactive arthritis refers to a type of spondyloarthritis that may be triggered by certain germs which cause gastroenteritis or urinary tract infections. Reiter’s syndrome is a form of reactive arthritis which may also affect the eyes and the skin.
Not all patients have classic signs and symptoms that fi t neatly into one of the categories outlined above, especially at the start of the illness. In such cases, the term, undifferentiated spondyloarthritis may be used.
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