Spondyloarthritis (Spondyloarthropathies)

What is spondyloarthritis?

Spondyloarthritis (or spondyloarthropathy) is the overall name for a family of inflammatory rheumatic diseases that can affect the spine and joints, ligaments and tendons. These diseases can cause fatigue and pain or stiffness in the back, neck, hands, knees, and ankles as well as inflammation of the eyes, skin, lungs, and heart valves. While there is no course of prevention at this time, treatment can reduce discomfort and delay the development of spinal deformities.

The term spondyloarthritis (also known as spondyloarthropathy) covers a group of closely related inflammatory diseases including arthritis of the spine (sacroiliitis or spondylitis) and peripheral joints; as well as inflammation in the area where ligaments and tendons attach to bones (enthesitis or enthesopathy). These diseases can cause pain in the spine, legs and arms as joints, ligaments, and tendons become inflamed and/or predispose patients to spinal vertebral fractures. Skin rashes, eye, and intestinal problems can also occur.

Diseases that fall under spondyloarthritis umbrella can include: 1) ankylosing spondylitis ; 2) reactive arthritis (known previously as Reiter's syndrome ) 3) psoriatic arthritis and psoriatic spondylitis, and 4) the arthritis or spondylitis associated with the inflammatory bowel diseases, ulcerative colitis and Crohn's disease. Still other patients may develop undifferentiated spondyloarthritis. This means they have symptoms or signs of one of the illnesses above, but don't develop the full blown disease.

What causes spondyloarthritis?

The exact cause of spondyloarthritis is unknown. However, researchers point to hereditary factors as playing an important role since these illnesses tend to occur more often in family members of patients who have spondyloarthritis. These patients usually share common genetic markers called HLA‐B27, which occurs in about seven percent of the population.

Other infections, such as chlamydia (which can cause urethritis or burning on urination) and bacteria that cause intestinal dysentery (such as types of salmonella, shigella, etc.), can trigger a certain type of reactive arthritis that is a form of spondyloarthritis. Beyond these, no specific infection has been linked to other types of the disease.

Who gets spondyloarthritis?

Spondyloarthritis tends to impact those in their teens and 20s, and young men two to three times more frequently than young women. (Psoriatic arthritis does affect young men and women equally). Family members of patients with spondyloarthritis run the highest risk of contracting these diseases, particularly those with HLA genes.

The highest frequency appears in the far north in cultures such as Alaskan and Siberian Eskimos and Scandinavians Lapps (Samis), as well as in certain Native America tribes in the western U.S. and Canada. African‐Americans are least frequently affected. About one in 200 Caucasians have spondyloarthritis.

Points to remember

• Spondyloarthritis is a type of arthritis that occurs in the spine and peripheral joints (hands, knees, ankles, etc.) that can also involve the skin, intestines, and eyes.
• Those in their teens and 20s, particularly males, are affected most often. Family members of spondyloarthritis patients are at the highest risk.
• Newer treatments have helped a great deal in controlling the symptoms and signs.