What is seronegative spondyloarthropathy (SpA)?
These are group of inflammatory arthritis which are characterised by inflammatory
low back pain in addition to peripheral arthritis. They are diagnosed by the presence
of:
- Asymmetrical oligoarthritis (lower limb >upper limb)
-Association with HLA-B27 allele
-Sacroiliitis and/or inflammatory spondylitis
- Enthesitis
- Anterior uveitis
- The rheumatoid factor (RF) is persistently negative.
SpA includes these five disorders:
1. Ankylosing spondylitis (M:F = 3:1, peak incidence in 2nd or 3rd decade with recurrent episodes of back pain which is marked in the morning; this inflammatory arthritis commonly affects the sacroiliac joint and spine (axial involvement), and ultimately progresses to bony fusion of the spine with marked stiffness in the body along with severe pain; there may be alternating buttock pain along with different peripheral joint involvement. Rest increases but exercise improves pain. There may be extra-articular manifestations like plantar fasciitis, Achilles tendonitis or aortic incompetence).
2. Reactive arthritis (previously known as Reiter’s syndrome): The classical triad of urethritis, conjunctivitis and arthritis following gastrointestinal (Salmonella, Shigella, Campylobacter or Yersinia-induced) or genitourinary (non-gonococcal urethritis or sexually acquired infection with Chlamydia) infection usually results in ReA. This inflammatory arthritis typically affects young men (or women), 1–3 weeks after an episode of bloody diarrhoea or sexual exposure with involvement of large joints of lower limbs. Circinate balanitis, keratoderma blennorrhagica and nail dystrophy are extra-articular manifestations.
3. Psoriatic arthropathy: The patients have psoriasis with different types of joint involvement like oligoarthritis, polyarthritis, involvement of DIP joints , spondylitis (back pain) or mutilation of
joints with deformity (arthritis mutilans).
4. Arthritis associated with inflammatory bowel diseases i.e., ulcerative colitis and Crohn’s disease (known as enteropathic arthritis).
5. Undifferentiated SpA.
NB: According to a few rheumatologists, the sixth group is juvenile-onset SpA.
These are group of inflammatory arthritis which are characterised by inflammatory
low back pain in addition to peripheral arthritis. They are diagnosed by the presence
of:
- Asymmetrical oligoarthritis (lower limb >upper limb)
-Association with HLA-B27 allele
-Sacroiliitis and/or inflammatory spondylitis
- Enthesitis
- Anterior uveitis
- The rheumatoid factor (RF) is persistently negative.
SpA includes these five disorders:
1. Ankylosing spondylitis (M:F = 3:1, peak incidence in 2nd or 3rd decade with recurrent episodes of back pain which is marked in the morning; this inflammatory arthritis commonly affects the sacroiliac joint and spine (axial involvement), and ultimately progresses to bony fusion of the spine with marked stiffness in the body along with severe pain; there may be alternating buttock pain along with different peripheral joint involvement. Rest increases but exercise improves pain. There may be extra-articular manifestations like plantar fasciitis, Achilles tendonitis or aortic incompetence).
2. Reactive arthritis (previously known as Reiter’s syndrome): The classical triad of urethritis, conjunctivitis and arthritis following gastrointestinal (Salmonella, Shigella, Campylobacter or Yersinia-induced) or genitourinary (non-gonococcal urethritis or sexually acquired infection with Chlamydia) infection usually results in ReA. This inflammatory arthritis typically affects young men (or women), 1–3 weeks after an episode of bloody diarrhoea or sexual exposure with involvement of large joints of lower limbs. Circinate balanitis, keratoderma blennorrhagica and nail dystrophy are extra-articular manifestations.
3. Psoriatic arthropathy: The patients have psoriasis with different types of joint involvement like oligoarthritis, polyarthritis, involvement of DIP joints , spondylitis (back pain) or mutilation of
joints with deformity (arthritis mutilans).
4. Arthritis associated with inflammatory bowel diseases i.e., ulcerative colitis and Crohn’s disease (known as enteropathic arthritis).
5. Undifferentiated SpA.
NB: According to a few rheumatologists, the sixth group is juvenile-onset SpA.