Spondyloarthropathy (patient information)
Overview
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Spondyloarthropathies are forms of arthritis that usually involve the bones of spine and surrounding joints. They can cause pain swelling of the joints and sometimes leads to destruction of joint such as backbones, shoulders, and hips. this destruction of the joints occasionally eventuate in limited spine rotation and movement.
What are the symptoms of Spondyloarthropathy?
The most common symptoms of spondyloarthropathies are pain, swelling, and stiffness, mostly appeared in the back and causes low back pain.
- axial spondylitis, mostly affect vertebra column and pelvic joints
- peripheral spondylitis, mostly affect arms and legs
- enthesitis, which is the inflammation of the point that tendons or ligament meets the bone, that firstly demonstrate itself by pain at the back or bottom of your heels
- Uveitis causes pain or redness in one eye
There are some possible symptoms associated with psoriasis same as skin rash or intestinal inflammatory disease such as ulcerative colitis.
Individuals with ankylosing spondylitis (AS) sometimes develop arthritis in their pelvic joints such as hip or shoulders, or both simultaneously early on. It also can mildly increase your body temperature due to inflammation in your body and can cause fatigue and reduction of your appetite.
If the disease does not treated properly the situation can be progressed and causes even the stiffer spine and its joints such as joints between your ribs and spine, since deep breathing can be hard.
What are the causes of spondyloarthropathies?
The exact cause of spondiloarthritis is not clear, albeit genetic play an obvious role in it, such that is called hereditary disease by some investigators. It has been mentioned that 30 different genes are responsible for appearing of spondyloarthropathies though there is one gene that are shared in all of them and it is HLA-B27. some other research suggest a link between bacteria and spondyloarthropathies or other inflammatory disease .
Studies also demonstrated that Reactive arthritis is the only type of spondyloarthritis known to be triggered by a bacterial infection.[1]
Who is at highest risk?
Since, the major gene that causes this disease is HLA-B27 and almost all white people with ankylosing spondylitis are carriers of HLA-B27, it is obvious that with people with the existence of any kind spondyloarthropathies in their family are at the higher risk of spondyloarthropathies.
To sum up individuals with one of the following criteria are at higher risk for spondyloarthropathies:
- positive test result for the HLA-B27 gene
- have a family member with spondyloarthritis
- are of Siberian Eskimo, Alaskan, or Scandinavian Lapps descent
- have another inflammatory condition, such as psoriasis or inflammatory bowel disease (Ulcerative colitis or Crohn's disease)
- have frequent bacterial infections in your gut[2][3]
When to seek urgent medical care?
You should seek medical care once each of the following symptoms are seen:
- morning stiffness in your back or any other joints that can be decreased by exercise.
limited rang of motion of your low back
Diagnosis
Diagnosis of spondyloarthropathy based on the clinical suspicious of physician triggered by the medical history and physical examination. The other step of diagnosis is blood tests and imaging modalities. X-ray of pelvis joints have been done to evaluate sacroiliac joint which is the most common joint involvement in spondyloarthropathy; inflamation of this joint called sacroilitis is the key sign of spondyloarthropathy. If the X-ray does not clarify the diagnosis of the disease further imaging modalities have been ordered such as magnetic resonance imaging (MRI) which can show the details of joints better than X-ray. Among all the blood tests HLA-B27 have been ordered to evaluate the existence of this gene. Howbeit, the existence of this gene does not mean the spondyloarthropathy will definitely develop.
Treatment options
Treatment options for spondyloarthropatheis are dependent on how severe the disease is. From first line drugs to the intensive treatment are included:[1]
- NSAID such as
- Corticosteroid
- Oral use or injection in swelled joint
- Disease-modifying antirheumatic drugs (DMARDs)
- Biologic drugs such as
Where to find medical care for spondyloarthropathy?
Direction to hospital for spondyloarthropathy
Prevention of spondyloarthropathy
Prevention of the spondyloarthropathy is not possible due to the nature of the condition.
What to expect (Outlook/Prognosis)?
Stiffness, fatigue, and pain can be continuous or on and off. Despite all of these symptoms, patients with spondyloarthropathy lead productive life and have normal lifespan as others. modifying life style can reduce the symptoms of disease such as quit smoking and have regular exercise.
possible complication
complication may occur in patient are included:
- osteoporosis
- uveitis
- inflammation of aortic valve
- IBDs ( inflammatory bowel disease )
- Psoriasis