Spondyloarthritides (SpA) - Edubirdie

University:
The University Of Western Ontario
Course:
Biology 2290F | Scientific Method in Biology
Academic year:

2022
Views:

106

Pages:

3
Author:

Kyuwon J.

Spondyloarthritides (SpA) ● Group of chronic inflammatory rheumatic disease ● Clinical radiological ● Axial inflammation ● Enthesitis ● Seronegativity RF Classifications ● Axial Spondyloarthritis ○ axSpA ■ Non-radiographic axSpA = absence of definite sacroiliitis in X-ray ○ Ankylosing spondylitis ■ AS ■ Radiographic sacroiliitis ■ Chronic inflammation could be observed ● Peripheral Spondyloarthritis ○ Psoriatic arthritis (PsA) ○ Reactive arthritis ○ IBD associated arthritis ○ Non-differentiated SpA Clinical Features ● Axial symptoms ○ Inflammatory back pain (IBP) ■ Onset < 40 y ■ Insidious ■ Improves on exercise ■ Absence of relief while in rest ■ Pain in night ● Peripheral symptoms ○ Arthritis ■ Asymmetric ■ Lower limb predominant ○ Enthesitis ■ Inflammation of the tendon ■ Inflammation in the ligament insertions such as Achilles ○ Extra-articular features ■ Uvitis, most common ■ Psoriasis ■ Inflammatory bowel disease ■ Aortic root dilation ● Conduction abnormalities Genetic immunologic ● HLA-B27 positive in most of cases of ankylosing spondylitis ○ 70-90% ● IL-17 and TNF ⇒ disease mechanism ● Strong family history Diagnostics ● Clinical ○ Inflammatory back pain ○ Peripheral arthrosis/enthesitis/dactylitis ● Lab ○ RF + anti-CCP ○ ESR/CRP increased by 50% ○ HLA-B27 used for indication ■ but cannot be used alone as a factor of diagnostics ● Imaging ○ MRI on sacroiliac joints ⇒ sensitive on early stage of disease ○ X-ray Tx ● Non-pharmacologic ○ Exercise and spinal extension ○ Smoking cessation ■ Will slow down the disease progression ○ Physiotherapy ● Pharmacologic ○ NSAIDs ○ TNF inhibitors ■ Adalimumab ■ Etanercep ○ IL-17 inhibitors ■ Secukinumab

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