Spondyloarthropathies Overview

Spondyloarthrophy: family of inflammatory arthritides characterised by involvement of both the spine and joints, principally in genetically predisposed (HLA B27 positive) individuals
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HLA B27

  • Diseases associated with the HLA B27 subtype can be remembered with the mneumonic PAIR - psoriatic arthritis, ankylosing spondylitis, IBS (+ enteropathic arthritis), reactive arthritis
  • Higher prevalence in the nothern hemisphere, especially Scandinavian countries

Shared features of the spondyloarthropathies

Shared rheumatological features

  • Sacroiliac and spinal involvement
  • Inflammatory arthritis - oligoarticular, asymmetric, predominantly lower limb
  • Synovitis: inflammation of joint and tendon sheath linings
  • Enthesitis: inflammation at sites where ligaments and tendons attach to bones e.g. Achilles tendinitis, plantar fasciitis
  • Dactylitis ('sausage' digits): inflammation of the entire digit

Shared extra-articular features

  • Ocular inflammation (anterior uveitis, conjunctivitis)
  • Mucocutaneous lesions
  • Rare aortic incompetence or heart block
  • No rheumatoid nodules