Wissenswertes

Spondyloarthropathies

Spondyloarthropathies

Spondyloarthropathies are a family of chronic (long term) diseases of joints. It is sometimes called spondyloarthritis. It affects children and adults. In the case of children these chronic disorders are called juvenile spondyloarthropaties. Spondyloarthropathies include illnesses such as ankylosing spondylitis, psoriatic arthritis, reactive arthritis/Reiter's syndrom, joint problems associated to inflammatory bowel disease (enterophatic arthritis) and undifferentiated (patients with features of more than one disease who do not fit in the defined categories above). Although these illnesses have different symptoms and outcomes there are a few similar symptoms for all of the such as:

  • The sacroiliac joint (attachments between the low back and the pelvic) is generally involved

  • The enthesitis (the areas around the joint where the ligaments and tendons attach to bone) are affected. Most commonly the symptomps can be first seen in knee, foot or the hips.

It is important to mention that spondyloarthropaties/spondyloarthritis are different diseases from rheumatoid arthritis (RA) in adults and juvenile idiophatic arthritis (JIA) in children.

In fact, it is not known what causes spondyloarthropathies, but research have found that patients with ankylosing spondylitis have the gene HLA-B27. Ankylosing spondylitis is the most commonly condition found in families followed by other forms of rheumatic disease such as lupus erythematosus or rheumatoid arthritis.

 

Symptoms of spondyloarthropathies

The common symptoms for all the spondyloarthropathies are:

  • Low back pain (it may spread into the buttock)

  • Morning stiffness, most commonly in the back or neck, (usually it gets better during the day and after exercising).

  • Fatigue.

In the followin section, the specific symptoms belonging to each type of spondyloarthropathies is presented:

  • Ankylosing spondylitis: This condition causes stiffness and low back pain. Over time, the pain usually moves from the lower back into the upper back. In severe cases, the affected joints in the spine fuse together, causing severe back stiffness. Other areas (such as the hips, chest wall, and heels) may also be affected. In children, symptoms usually begin in the hips, knees, heels, or big toes and later move to the spine.

  • Reactive arthritis: This illness causes pain, swelling, and inflammation of the joints, especially in the sacroiliac joint (the attachment between the lower back and pelvis) and in the fingers, toes, and feet. The fingers and toes may swell, causing a "sausage digit." Other symptoms may appear such as fever, weight loss, skin rash and inflammation. In children, the joints of the lower legs are most commonly affected.

  • Psoriatic arthritis: This disease occurs when psoriasis (scaly red patches on the skin) is present. Patients with this condition may also develop arthritis as time passes. The symptoms include pitting or thickening and yellowing fingernails and toenails. The hips and sacroiliac joints are involved and the whole toes or fingers are swollen (sausage digits).

  • Enteropathic arthritis: This spinal arthritis causes also inflammation of the intestinal wall. Symptoms may come and go. If the pain in the abdomen is flaring, this arthritis may also flare. Large joints such as the knees, hips, ankles, and elbows are most commonly affected. In children, the arthritis may begin before the intestinal inflammation.

Diagnosing and treatment of spondyloarthropathies

Spondyloarthropathies are diagnosed by considering the medical history of the patient and by conducting lab tests, imaging tests such as an X-ray or Magnetic Resonance Images (MRI) and by the presence of symptoms of joint and tissue inflammation, morning stiffness, and other symptoms unique to a specific spondyloarthropathy such as scaly skin in the case of psoriatic arthritis. Some different types of tests may be done for the different spondyloarthropathies. After being diagnosed, the pain and stiffness can be relieved with natural home remedies or NSAIDs (nonsteroidal anti-inflammatory drugs) in order to treat pain and inflammation, and with good postures and stretching exercises to prevent stiffening and deformity but if the spondyloarthropathy is severe such as enterophatic arthritis then other medicines are used to treat the intestinal inflammation.