spondyloartropatiat

Spondyloartropatiat, also referred to as spondyloarthropathy, is a group of inflammatory rheumatic diseases that primarily affect the spine and sacroiliac joints, often accompanied by enthesitis (inflammation at tendon or ligament insertion sites) and peripheral arthritis. The condition is heterogeneous and overlapping with other inflammatory diseases, and it typically begins before age 40.

The group includes axial spondyloarthritis, which chiefly involves the spine and sacroiliac joints, and peripheral spondyloarthritis, which affects peripheral joints and entheses. Distinct the main subtypes are ankylosing spondylitis, psoriatic arthritis, reactive arthritis, arthritis associated with inflammatory bowel disease, and juvenile spondyloarthritis. The conditions share clinical features such as inflammatory back pain, morning stiffness, reduced spinal mobility, enthesitis (for example at the Achilles tendon), and dactylitis. Extra-articular manifestations may include uveitis, psoriasis, and inflammatory bowel disease.

Diagnosis relies on a combination of clinical evaluation, imaging, and laboratory tests. Imaging (MRI or X-ray) can reveal sacroiliitis and characteristic spinal changes; HLA-B27 positivity supports the diagnosis in many patients. Laboratory findings often show elevated inflammatory markers (CRP, ESR) but are not specific. Diagnostic criteria from organizations such as ASAS are used to classify axial spondyloarthritis.

Treatment aims to reduce inflammation, relieve pain, maintain mobility, and prevent deformity. First-line therapy typically includes NSAIDs and physical therapy. For peripheral arthritis or axial disease refractory to NSAIDs, disease-modifying antirheumatic drugs (DMARDs) and biologic agents (e.g., TNF inhibitors, IL-17 inhibitors) may be employed. Management also involves treating comorbidities, vaccination, lifestyle modification, and regular monitoring of disease activity and function. Prognosis varies by subtype and early treatment, but chronicity is common with potential progression to reduced spinal mobility.

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