What Are the Types of Spondyloarthropathies?

Spondyloarthropathies are forms of arthritis that usually strike the bones in your spine and nearby joints. They can cause pain and sometimes damage joints like your backbone, shoulders, and hips.

Arthritis causes inflammation (swelling, redness and pain) in your body’s joints. It’s common in people as they get older. Spondyloarthropathies cause arthritis at the points where your bones connect to soft tissues like ligaments and tendons connect to bones and muscles.

What Are the Types?

The most common form is called “ankylosing spondylitis.” It attacks joints between the bones that make up your spine (vertebrae). But there are other forms as well:

  • Undifferentiated spondyloarthropathy produces symptoms that aren’t as specific as other illnesses in this family. It sometimes develops into a more identifiable form of the disease.
  • Reactive arthritis often develops after an infection in the urinary tract or digestive system. It tends to attack joints in the lower limbs.
  • Reiter’s syndrome is a type of reactive arthritis that happens as a reaction to an infection in another part of your body. It can include redness, joint swelling and pain, often in knees, ankles, and feet.
  • Psoriatic arthritis affects major joints of the body, as well as the fingers and toes, along with the back and pelvis. It typically happens to people who have a skin condition called psoriasis or who have family members with psoriasis.
  • Enteropathic spondyloarthropathy. People who have a digestive tract illness like Crohn’s disease sometimes get this condition. About 1 in 5 people who suffer from Crohn’s or ulcerative colitis will get this form of spondyloarthopathy.

Who Gets Them?

Slightly under 1% of American adults have some sort of spondyloarthritis condition. That’s about 1.7 million people.

In some people, it may be genetic. That means it’s something you’re more likely to get if your parents or someone else in your family has had it.

Men are up to three times more likely to have it than women. The symptoms can start showing up as early as your late teens.

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Symptoms

Back pain is the most common symptom of a spondyloarthropathy. But there are a variety of other symptoms that might point to an illness of this type:

  • Joints like your hips, shoulders, knees, or elbows are painful and swollen.
  • The points where your tendons and ligaments meet bone become inflamed. This is called enthesitis. The first sign is usually a pain at the back or bottom of your heels.
  • Dactylitis is an inflammation of the tendons in the fingers and toes. This gives them a swollen, sausage-like appearance.
  • Uveitis causes pain or redness in one eye.

Other possible signs are a skin rash associated with psoriasis, or an inflammatory intestinal illness.

People with ankylosing spondylitis sometimes develop arthritis in their hips and shoulders early on. It also can make you feel fatigued or lose your appetite. You might run a mild fever.

In severe cases, it can make your spine stiffer. It also could damage the vertebrae or cause two or more of the bones to grow together. That can make it harder for your rib cage to move. Taking a deep breath can be hard.

How Are They Diagnosed?

If your doctor suspects you have a spondyloarthropic condition, she will examine your body and joints and review your medical records.

You might be asked to undergo an X-ray or another type of imaging test to look at the joints in the pelvis (lower belly), which can show early signs of spondyloarthritis.

And a blood test might show your doctor whether you carry a gene that increases your risk of spondyloarthropathies. It’s called HLA-B27.

What Are the Treatments?

There are no known cures , but your doctor can help you manage your condition.

Your treatment will likely involve a rheumatologist. This is a doctor who specializes in treating diseases like arthritis.

Depending on what type of spondyloarthropathy you have, you might also see these experts:

  • Physical therapist. Exercise and physical therapy can help keep your joints flexible.
  • Gastroenterologist. This specialist deals with diseases of the digestive system.
  • Ophthalmologist. If you have a condition that affects your vision, you’ll need to see an eye doctor.

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Usually, the first step is to use a nonsteroidal anti-inflammatory drug (NSAID). The most common kinds are aspirin, ibuprofen or naproxen. They relieve pain and reduce swelling in the affected joints.

If your symptoms don’t improve after taking NSAIDs, you might be prescribed a more powerful class of drug.

  • For quick but temporary pain relief, you might get a shot of corticosteroids in a particularly sore joint.
  • If you have reactive arthritis, you might be given antibiotics.
  • Another class of drugs, known as disease-modifying antirheumatic drugs (DMARDs), might be prescribed to help treat arthritis in the arms and legs.
  • TNF inhibitors block a chemical in the blood that causes inflammation.

If your illness has taken a heavy toll on your joints, your doctors might consider surgery to replace them with an artificial joint. Knee and hip replacements are the most common type of surgery.

In some cases, doctors might perform surgery to straighten your spine when the vertebrae have fused together in a forward-curving position. This is considered a high-risk operation.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on April 03, 2017

Sources

SOURCES:

American College of Rheumatology:” Spondyloarthritis.”

American Family Physician: “Spondyloarthropathies.”

Spondylitis Association of America.

World Journal of Orthopedics: “Classification criteria for spondyloarthropathies.”

Arthritis Care and Research: “Prevalence of axial spondyloarthritis in the United States.”

Annals of Internal Medicine: “Update on Spondyloarthropathies.”

University of Maryland Medical Center: “Reiter syndrome.”

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