What are Spondyloarthropathies?

Spondyloarthropathies are a class of related diseases, all of which affect the bones of the spine and other joints. They resemble arthritis in many ways, and are often characterized by inflammation of the spine, as well as the tissues that surround it. Many patients who present with one of the several types of spondyloarthropathies also experience inflammation of the skin, eyes, and bowel, among other areas. Spondyloarthropathies can present as one specific type, or can be undifferentiated, in which some symptoms of more than one type are present. The causes of these diseases are largely unknown, although it appears that there is a certain genetic predisposition to them in some patients.

One type of spondyloarthropathy is ankylosing spondylitis (AS). This is a chronic inflammation of the spine, involving its joins and ligaments. Pain and stiffness often result from this inflammation. If AS is not treated properly, it may result in the fusing of the vertebrae, and rigidity of the spine.

The severity of AS varies from patient to patient, and it typically strikes around early adulthood. The progression of AS tends to be slow, non-life threatening, and does not usually require large adjustments in lifestyle unless it is severe. Treatments tend to focus on pain relief, since there is no known treatment to cure or reverse the progression of AS.

Reactive arthritis (ReA)is another member of the family of spondyloarthropathies. Its scope is not limited to the spine, and it can affect one or more joints at the same time. ReA tends to be self-limiting, often lasting less than a year. For patients with chronic ReA, its progression is not always in a straight line, but can oscillate between improvement and relapse. Inflammation can be present in tissues that are unrelated to the joints as well, but all inflammation due to ReA is non-infectious.

Enteropathic arthritis is another of the spondyloarthropathies. It typically affects the joints of the lower extremities, and is often accompanied by inflammatory bowel disease. It affects mainly the young, and can sometimes involve the spine, especially in those with the gene that most people with AS have. Physical therapy, pain relief, and exercise are the forms of treatment generally used, as is the case with the other spondyloarthropathies.

When a spondyloarthropathy is undifferentiated, the patient suffers from a combination of the above symptoms that does not lend itself to diagnosis as a specific type. This lack of differentiation can lead to the disease initially being misdiagnosed as fibromyalgia or another disease characterized by chronic pain. Undifferentiated spondyloarthropathy can progress to AS, but generally has a good prognosis over time.