J Braun, M Rudwaleit, J Sieper
Der Internist 2011, 52 (6): 657-70
Spondyloarthritides are a group of inflammatory rheumatic disorders related by clinical symptoms and genetic predisposition; the most important subtype is ankylosing spondylitis. The other subtypes include psoriatic spondyloarthritis, after preceding infections, in association with chronic inflammatory bowel diseases, and undifferentiated spondyloarthritis. The most significant clinical symptoms are inflammatory back pain and peripheral, usually asymmetric oligoarthritis and enthesitis. The possibility of other organs being involved is typical to some extent and the frequency varies among the subtypes: particularly affected are the eyes, the skin, and the intestines. Less commonly aortic valve defects and arrhythmias occur. The strongest genetic factor is the MHC class I molecule HLA-B27, which is exhibited by 90% of the patients with ankylosing spondylitis. The diagnostic possibilities for early identification have improved in the last few years. Early determination of HLA-B27 and magnetic resonance imaging have contributed to this development. Conventional radiography still represents the gold standard in the diagnostic workup. New criteria for classification of axial and peripheral spondyloarthritis have recently become available and international recommendations for the management of ankylosing spondylitis were recently published.

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