Spondylarthritis, also called spondyloarthritis or spondyloarthropathy, is a family of arthritic conditions that affect the spine and, in rare cases, joints in the arms and legs. Whereas other forms of arthritis involve the joints, spondylarthritis involves the enthesis or area where the ligaments and bones connect.
The most common type of spondylarthritis is called ankylosing spondylitis, but other forms include psoriatic arthritis, reactive arthritis (Reiter’s syndrome) and enteropathic arthritis which affect the gastrointestinal tract and bladder, skin and bowel, respectively.
The onset of spondylarthritis presents with low back pain, as well as occasional swelling in the arms and legs, joint inflammation and fatigue. If left untreated, spondylarthritis can cause vertebrae fusion in the spine. According to the Arthritis Foundation, other problems that can occur alongside spondylarthritis include:
- pain and redness in the eyes;
- psoriasis; and
- inflammation of the intestines and heart valve.
The cause of spondylarthritis is largely unclear, though genetics play a major role in the development of this condition, according to the Arthritis Foundation.
Most Caucasian patients with the disease carry the HLA-B27 gene, though not every person with the HLA-B27 gene will develop spondyloarthritis.
Specifically, young men in their teens and 20s are most at risk for developing spondyloarthritis, according to the American College of Rheumatology. Additionally, spondyloarthritis frequently occurs in Native Americans from the western U.S. and Canada, as well as in Alaskans, Siberians, Eskimos and Scandinavian Lapps[MG1] .
A physician or rheumatologist will diagnose spondyloarthritis through a series of tests, which include:
- a detailed medical history;
- a physical examination;
- a blood test to look for the HLA-B27 gene;
- an X-ray to measure a specific type of joint inflammation called sacroiliitis; and
- an MRI if the X-ray results are inconclusive.
However, according to the American College of Rheumatology, the final diagnosis relies heavily on the judgement of the physician.
Spondyloarthritis treatment focuses on exercise and movement with various drug treatment options, according to the American College of Rheumatology. Treatments for spondyloarthritis include:
- physical therapy of the joints;
- mobility exercises;
- NSAIDs for pain relief; and
- corticosteroid injections to address joint swelling.
According to the American College of Rheumatology, some patients may not respond to firstline treatment options. Other treatments may include:
- disease modifying anti-rheumatic drugs (DMARDS);
- anti-tumor necrosis factor drugs; and
- surgery, in cases of cartilage loss.