Spondyloarthropathy
Encyclopedia
Spondyloarthropathy is any joint disease of the vertebral column
. Spondyloarthropathy with inflammation is called spondylarthritis. In contrast, spondylopathy is a disease of the vertebra itself, but many conditions involve both spondylopathy and spondyloarthropathy. 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:
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 what is commonly seen in rheumatoid arthritis
.
Some sources also include Behcet's disease
and Whipple's disease
.
Vertebral column
In human anatomy, the vertebral column is a column usually consisting of 24 articulating vertebrae, and 9 fused vertebrae in the sacrum and the coccyx. It is situated in the dorsal aspect of the torso, separated by intervertebral discs...
. Spondyloarthropathy with inflammation is called spondylarthritis. In contrast, spondylopathy is a disease of the vertebra itself, but many conditions involve both spondylopathy and spondyloarthropathy. In the broadest sense, the term spondyloarthropathy includes joint involvement of vertebral column from any type of joint disease, including rheumatoid arthritis
Rheumatoid arthritis
Rheumatoid arthritis is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The process produces an inflammatory response of the synovium secondary to hyperplasia of synovial cells, excess synovial fluid, and the development...
and osteoarthritis
Osteoarthritis
Osteoarthritis also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion...
, but the term is often used for a specific group of disorders with certain common features, the group often being termed specifically seronegative spondylarthropathies:
Seronegative spondylarthropathy
Seronegative spondyloarthropathy (or seronegative spondyloarthritis) is a group of diseases involving the axial skeletonAxial skeleton
The axial skeleton consists of the 80 bones along the central axis of the human body. It is composed of six parts; the human skull, the ossicles of the middle ear, the hyoid bone of the throat, the rib cage, sternum and the vertebral column...
and having a negative serostatus
Serostatus
Serostatus is a term used to refer to the presence or absence of specific substances in the blood serum. Most commonly, this medical test is looking for specific antibodies in an effort to diagnose a particular disease....
.
"Seronegative" refers to the fact that these diseases are negative for rheumatoid factor
Rheumatoid factor
Rheumatoid factor is an autoantibody most relevant in rheumatoid arthritis. It is defined as an antibody against the Fc portion of IgG. RF and IgG join to form immune complexes that contribute to the disease process...
, indicating a different pathophysiological mechanism of disease than what is commonly seen in rheumatoid arthritis
Rheumatoid arthritis
Rheumatoid arthritis is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The process produces an inflammatory response of the synovium secondary to hyperplasia of synovial cells, excess synovial fluid, and the development...
.
Conditions
The following conditions in the table are typically included within the group of seronegative spondylarthropathies:| Condition | Percent of people with the condition who are HLA-B27 HLA-B27 Human Leukocyte Antigen B27 is a class I surface antigen encoded by the B locus in the major histocompatibility complex on chromosome 6 and presents antigenic peptides to T cells... positive |
|---|---|
| Ankylosing Spondylitis Ankylosing spondylitis Ankylosing spondylitis , previously known as Bekhterev's disease, Bekhterev syndrome, and Marie-Strümpell disease is a chronic inflammatory disease of the axial skeleton with variable involvement of peripheral joints and nonarticular structures... |
|
| Reactive arthritis Reactive arthritis Reactive arthritis , is classified as an autoimmune condition that develops in response to an infection in another part of the body. Coming into contact with bacteria and developing an infection can trigger the disease. Reiter's syndrome has symptoms similar to various other conditions collectively... (Reiter's syndrome) |
60-80% |
| enteropathic spondylitis or spondylitis associated with inflammatory bowel disease Inflammatory bowel disease In medicine, inflammatory bowel disease is a group of inflammatory conditions of the colon and small intestine. The major types of IBD are Crohn's disease and ulcerative colitis.-Classification:... (including Crohn's disease Crohn's disease Crohn's disease, also known as regional enteritis, is a type of inflammatory bowel disease that may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms... and ulcerative colitis Ulcerative colitis Ulcerative colitis is a form of inflammatory bowel disease . Ulcerative colitis is a form of colitis, a disease of the colon , that includes characteristic ulcers, or open sores. The main symptom of active disease is usually constant diarrhea mixed with blood, of gradual onset... ) |
60% |
| Psoriatic arthritis Psoriatic arthritis Psoriatic arthritis is a type of inflammatory arthritis that, according to the National Psoriasis Foundation, will develop in up to 30 percent of people who have the chronic skin condition psoriasis... |
60% |
| Isolated acute anterior uveitis | 50% |
| Undifferentiated spondyloarthropathy (USpA) | 20-25% |
Some sources also include Behcet's disease
Behçet's disease
Behçet's disease is a rare immune-mediated systemic vasculitis that often presents with mucous membrane ulceration and ocular involvements...
and Whipple's disease
Whipple's disease
Whipple's disease is a rare, systemic infectious disease caused by the bacterium Tropheryma whipplei. First described by George Hoyt Whipple in 1907 and commonly considered a gastrointestinal disorder, Whipple's disease primarily causes malabsorption but may affect any part of the body including...
.
Common characteristics
These diseases has following conditions in common:- They are in relation to HLA-B27HLA-B27Human Leukocyte Antigen B27 is a class I surface antigen encoded by the B locus in the major histocompatibility complex on chromosome 6 and presents antigenic peptides to T cells...
- Inflammatory arthritis, generally sacroiliitisSacroiliitisIn medicine, sacroiliitis is an inflammation of the sacroiliac joint. Sacroiliitis is a feature of spondylarthropathies .-External links:*...
and spondylitisSpondylitisSpondylitis is an inflammation of the vertebra. It is a form of spondylopathy. In many cases, spondylitis involves one or more vertebral joint as well, which itself is called spondylarthritis.-Examples:... - OligoarthritisOligoarthritisOligoarthritis is defined as arthritis affecting one to four joints during the first six months of disease.- Types :Two subcategories are recognized:* Persistent oligoarthritis: Affecting not more than 4 joints throughout the disease course...
, generally with asymmetrical presentation - EnthesitisEnthesitisEnthesitis is inflammation of the entheses, the sites where tendons or ligaments insert into the bone. It is also called enthesopathy, or any pathologic condition involving the entheses. The entheses are any point of attachment of skeletal muscles to the bone, where recurring stress or...
(inflammationInflammationInflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
of the entheses, the sites where tendons or ligaments insert into the bone.) - familial aggregation occurs
- rheumatoid factorRheumatoid factorRheumatoid factor is an autoantibody most relevant in rheumatoid arthritis. It is defined as an antibody against the Fc portion of IgG. RF and IgG join to form immune complexes that contribute to the disease process...
is not present - Extra-articular features, such as involvement of eyes, skin and genitourinary tract
- OverlapOverlapOverlap may mean one of:* In music theory, overlap is a synonym for reinterpretation of a chord at the boundary of two musical phrases.* In railway signalling, an Overlap is the length of track beyond a stop signal that is proved to be clear of vehicles in the controls of the previous signal, as a...
is likely between several of the causative conditions
External links
- http://www.gpnotebook.co.uk/simplepage.cfm?ID=-254803955
- Information from the American College of RheumatologyAmerican College of RheumatologyThe American College of Rheumatology is an organization of and for physicians, health professionals, and scientists that advances rheumatology through programs of education, research, advocacy and practice support that foster excellence in the care of people with arthritis and rheumatic and...
- Spondyloarthropathies: Update on Diagnosis and Treatment from ConsultantLive.