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Spondyloarthritis

We have talked about ankylosing spondylosis in the past. It is an inflammatory disease that is part of a group of diseases named spondyloarthritis(SpA) in 2009. Spondyloarthritis  essentially means arthritis of the spine.

Over 3.2 million adults have a form of the disease which usually starts under the age of 45.  It is a larger number than RA, Lupus and MS combined. Women are affected. It was once thought to be a disease of men. The symptoms are a little different for women.

The Spondylitis Association of America divides the individual diseases into two overlapping groups.

Group one

This group includes axial spondyloarthritis and non-radiographic axial spondyloarthritis. These diseases affect the spine and pelvic girdle. Both can be severe disease. They range from disease with spinal changes seen on x-ray to disease with no noticeable spinal changes seen on x-ray.

Axial spondyloarthritis(AxSpA)

  • Commonly called ankylosing spondylitis, affecting the spine where fusing changes are seen on x-ray.

Non-radiographic axial spondyloarthritis (nr-AxSpA)

  • Primarily affects the spine without the characteristic bone changes seen on x-ray. Women are more likely to have this type. One of the reasons women have a harder time receiving a diagnosis is because they do not have the radiographic changes on x-ray and their symptoms may be different than those for men.  For example, men might have symptoms including the lower spine. Women might have symptoms involving the cervical spine.

Overlapping the two groups:

Juvenile Spondyloarthritis (JSpA) It is hard to imagine young children suffering from this disease. Some children may have predominantly spinal symptoms. Other children may have predominately peripheral symptoms with pain and arthritis occurring in the hips, knees and ankles. Juvenile Spondyloarthritis incudes subcategories of all the spondyloarthritis diseases that adults have. Spondykids.org.

Group two

This group of related diseases also includes pain and inflammation in joints in the peripheral joints of the body.

Psoriatic arthritis (PsA) causes pain and swelling of the small joints of the hands and feet.  It is preceded by psoriasis which causes scaly patches on the skin. It may also affect the spine.

Enteropathic Arthritis(EnA) is an inflammatory spinal and joint arthritis associated with an inflammatory intestinal  disease such as Crohn’s, ulcerative colitis and undifferentiated colitis.

Reactive Arthritis (ReA) is caused by an infection usually in the intestines or urinary tract. It is limited in nature but is inclined to reoccur and may develop into a chronic arthritis. It may cause pain and inflammation in the joints, skin, eyes, bladder, genitals, and mucous membranes. Occasionally, it will affect the spine.

Undifferentiated spondyloarthritis (USpA) is a disease with characteristics of spondyloarthritis but doesn’t fit into any of the above categories.

It just goes to reinforce the notion that one size does not fit all.

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