Spondyloarthritides

The spondyloarthritides are a diverse group of distinct yet interrelated disease processes with overlapping clinical features. They comprise ankylosing spondylitis, reactive arthritis, inflammatory bowel disease–associated arthritis, and psoriatic arthritis. Genetically, these disease processes have been linked by the presence of HLA-B27. They manifest with axial and peripheral symptoms, such as inflammatory back pain, enthesitis, oligoarthritis, and dactylitis. The onset of symptoms can begin before the age of 45; however, because of the wide range of signs and symptoms, diagnosis can be delayed, leading to unchecked inflammation, structural damage, and, later, restriction in physical mobility.

Therefore, it is important to suspect spondyloarthritis early on in patients with appropriate history and physical examination findings. Prompt recognition is becoming more important, as effective therapies for early treatment have become available, and it is possible to prevent the debilitating long-term effects of the disease.