Spondyloarthritis: Difference between revisions
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== Clinically Relevant Anatomy == | == Clinically Relevant Anatomy == | ||
Spondyloarthritis is the overall name for a family of inflammatory rheumatic diseases. <ref name="1">Braun J. et al, Spondyloarthritides, Internist., 2011 May 19: 5 : 2C</ref><ref name="2">Braun J., Sieper J., Spondyloarthritides., Z Rheumatol. 2010 Jul; 69(5):425-32 :4: 2C</ref> | |||
Due to this fact, there is a large complexity. This is because there are several anatomic structures involved. We can assume that the inflammation can occur on all the joints of the spine. The facet joints, endplates, bone marrow, … every part of the spine can be affected by an inflammation. <ref name="4">Walter P. Maksymowych, Frpc, Magnetic Resonance Imaging for Spondyloarthritis — Avoiding the Minefield (https://jrheum.com/subscribers/07/02/259.html) 4</ref> Sacroiliitis in SpA is characterized by involvement of different joint structures. Whereas the iliac and the sacral side of the sacroiliac joints are almost equally affected, the dorsocaudal synovial part of the joint is involved significantly more often than the ventral part, especially in early disease. Sacroiliac enthesitis is not a special feature of early sacroiliac inflammation. There is a difference between axial and peripheral spondyloarthitis, with axial spondyloarthitis back pain and inflammation of the sacroiliac joints are the main complaints. In peripheral spondyloarthritis, the inflammation of peripheral joint and tendons are the main complaints. Further, spondyloarthritis can show an inflammation of peripheral joints (for example, knees and ankles), and tendons (for example, the Achilles tendon).<ref name="1">Braun J. et al, Spondyloarthritides, Internist., 2011 May 19: 5: 2C</ref><ref name="2">Braun J., Sieper J., Spondyloarthritides., Z Rheumatol. 2010 Jul; 69(5):425-32 :4: 2C</ref><ref name="3">Reveille J.D., Americain college of Rheumatology, 2005 Jun 5: 5</ref><ref name="4">Walter P. Maksymowych, Frpc, Magnetic Resonance Imaging for Spondyloarthritis — Avoiding the Minefield (https://jrheum.com/subscribers/07/02/259.html) 4</ref><br> | |||
== Epidemiology /Etiology == | == Epidemiology /Etiology == | ||
Revision as of 22:36, 31 December 2014
Original Editors - Els Bernaers
Top Contributors - Julie Schuermans, Kim Jackson, Els Bernaers, Admin, Rachael Lowe, Candace Goh, Lucinda hampton, 127.0.0.1, WikiSysop and Sehriban Ozmen
Search Strategy[edit | edit source]
We used following databases:
• Pubmed
• Web of Knowledge
• Web of Science
• PEDro
The most frequently search terms:
• Spondyloarthritis
• Relevant structures
• Medical management
• Physical therapy
• Treatment
• Etiology
• Relevant anatomy
• …
Definition/Description[edit | edit source]
Spondyloarthritis is a name of a group of diseases that is included in a larger term 'arthritis'.[1][2][3][4] Inflammation can occur in spine, sacroiliac and peripheral joints as well near the attachments of tendons and ligaments.[3][4][5] This disease provokes to pain, stiffness and fatigue in back, legs and arms as in joints, ligaments and tendons.[3][6][7] Eruption, eye and intestinal problems may also occur.[1][3][4]
Spondyloarthritis in adults can be subdivided more specifically:[1][2][3][8][9][10][11]
- ankylosing spondylitis or Bechterew disease
- psoriatic arthritis[12]
- reactive arthritis[13]
- enteric arthritis
- undifferentiated arthritis
Clinically Relevant Anatomy[edit | edit source]
Spondyloarthritis is the overall name for a family of inflammatory rheumatic diseases. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Due to this fact, there is a large complexity. This is because there are several anatomic structures involved. We can assume that the inflammation can occur on all the joints of the spine. The facet joints, endplates, bone marrow, … every part of the spine can be affected by an inflammation. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Sacroiliitis in SpA is characterized by involvement of different joint structures. Whereas the iliac and the sacral side of the sacroiliac joints are almost equally affected, the dorsocaudal synovial part of the joint is involved significantly more often than the ventral part, especially in early disease. Sacroiliac enthesitis is not a special feature of early sacroiliac inflammation. There is a difference between axial and peripheral spondyloarthitis, with axial spondyloarthitis back pain and inflammation of the sacroiliac joints are the main complaints. In peripheral spondyloarthritis, the inflammation of peripheral joint and tendons are the main complaints. Further, spondyloarthritis can show an inflammation of peripheral joints (for example, knees and ankles), and tendons (for example, the Achilles tendon).Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Epidemiology /Etiology[edit | edit source]
add text here
Characteristics/Clinical Presentation[edit | edit source]
It is characteristic of spondyloarthritis that pain, stiffness and fatigue occurred in back, legs and arms as in joints tendons and ligaments. It is difficult to describe the typical characteristics, mostly because it is a mix of diseases.
These diseases have a variety possible common characteristics.[2][6][7][9][12][14][15]
- inflammatory back pain
- osteoporosis
- spinal fractures
- peripheral arthritis, usually assymetric, relatively more in the lower limbs.([2][7])
- enthesitis
- dactylitis
- inflammation of the haert valve – pneumonia
- extraarticulaire disorders such as uveitis, skin porosiasis or inflammatory bowel disease
- strong familial aggregation of spondyloarthritis, psoriasis, IBD, uveitis
- association with HLA-B27
- no increased CRP and rheumatoid factor.
The symptoms vary depending on what type of spondyloarthritis the cause.[3][6][7][9][10][12] Disease progression and severity of symptoms vary greatly between individuals. The disease is subject to ups and downs.[10]
Differential Diagnosis[edit | edit source]
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Diagnostic Procedures[edit | edit source]
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Outcome Measures[edit | edit source]
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Examination[edit | edit source]
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Medical Management
[edit | edit source]
There is a wide range of pharmacological remedies to reduce the symptoms of spondyloarthritis. For example, NSAIDs, DMARD'S, corticosteroids, antibiotics and TNF-alpha blockers, each with their own specific improvement.[3][7][11][12][13][16] Whit some patients, a surgical treatment is recommended but this the widespread complications of the disease severity must be considered.[3]
Physical Therapy Management
[edit | edit source]
Physiotherapy
Apart from a drug treatment, physiotherapy is recommended.[5][11][17]
Education, for the patient and the further course of the disease, is helpful.[6]
It is important to start the treatment early to avoid chronic symptoms and loss of function as much as possible.[5][18][17]
It is important for these patients to do daily special stretching and strengthening exercises to maintain the strength and mobility in the joints and reduce pain and stiffness.[3][17][19]
Special attention should be given to a good posture of the patient.[17]
Key Research[edit | edit source]
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Resources
[edit | edit source]
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Clinical Bottom Line[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
see adding references tutorial.
- ↑ 1.0 1.1 1.2 Braun J. et al, Spondyloarthritides, Internist., 2011 May 19
- ↑ 2.0 2.1 2.2 2.3 Braun J., Sieper J., Spondyloarthritides., Z Rheumatol. 2010 Jul; 69(5):425-32
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 Reveille J.D., Americain college of Rheumatology, 2005 Jun http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/spondyloarthritis.asp
- ↑ 4.0 4.1 4.2 Van Der Heijde D.M.F.M., Spondyloarthritis onderzoek – SPACE, Leids universitair Medisch Centrum, http://www.lumc.nl/con/2096/82547/81117042303221/
- ↑ 5.0 5.1 5.2 Van Reesema S., Zwart N., Spondylo-artritis, Ziekenhuis Deventer, http://www.dz.nl/reuma/folders/toonfolder-1056.html
- ↑ 6.0 6.1 6.2 6.3 Sieper J. et al, The assessment of spondyloarthritis International society handbook: a guide to assess spondyloarthritis., Ann Rheum Dis., 2009;68;1-44
- ↑ 7.0 7.1 7.2 7.3 7.4 Mease P.J., Psoriatic arthritis – update on pathophysiology, assessment, and management., Bull NYU Hosp Jt Dis.,2010;68(3):191-8
- ↑ Buschiazzo E. et al, Epidemiology of spondyloarthritis in Argentina, Am J Med Sci. 2011 Apr; 341(4):289-92
- ↑ 9.0 9.1 9.2 Van Den Berg R., How should we diagnose spondyloarthritis according to the ASAS classification criteria: a guide for practicing physicians, Pol Arch Med Wewn., 2010(11):452-7
- ↑ 10.0 10.1 10.2 Roussou E., Sultana S., Early spondyloarthritis in multiracial society: differences between gender, race, and disease subgroups with regard to first symptom at presentation, main problem that disease is causing to patients, and empolyment status., Rheumatol Int. 2011 Feb 17
- ↑ 11.0 11.1 11.2 Braun J., Therapy of spondyloarthritides. Adv Exp Med Biol., 2009;649:133-47
- ↑ 12.0 12.1 12.2 12.3 Slobodin G. et al, Psoriatic arthropathy: where now?, Isr Med Assoc J., 2009 Jul;11(7):430-4
- ↑ 13.0 13.1 Carter J.D. et al, Combination antibiotics as a treatment for chronic Chlamydia-induced reactive arthritis: a double blind, placebo controlled, prospective trial., Arthritis Rheum., 2010 May;62(5): 1298-307
- ↑ Slobodin G., Recently diagnosed axial spondyloarthritis: gender differences and factors related to delay in diagnosis., Clin Rheumatol., 2011 Mar 1
- ↑ Colbert R.A., Early axial spondyloarthritis., Curr Opin Rheumatol., 2010 Sep;22(5):603-7
- ↑ Rudwaleit M. et al, Effectiveness and safety of adalimumab in patients with ankylosing spondylitis or psoriatic arthritis and history of anti-tumor necrosis factor therapy., Arthritis Res Ther., 2010;12(3):R117
- ↑ 17.0 17.1 17.2 17.3 Maddali Bongi S., Del Rosso A., How to prescribe physical exercise in rheumatlogy., Reumatismo., 2010 Jan- mar;62(1):4-11
- ↑ Karapolat H. et al, Are swimming or aerobic excercise better than conventional excercise in ankylosing spondylitis patients? A randomized controlled study, Eur J Phys Rehabil Med., 2009 Dec;45(4):449-57
- ↑ Coronado R.A. et al, Spondyloarthritis in a patient with unilateral buttock pain and history of Chrohn disease., Phys Ther., 2010 May;90(5):784-92
