Spondyloarthritis -Recognition and referral

Spondyloarthritis ( SpA ) represents a group of interrelated diseases with common clinical features and a close association with HLA-B27 ( Stolwkj et al Rheum Dis Clin North Am 2015 )

Axial spondyloarthritis -Radiographic axial spondyloarthritis ( ankylosing spondylitis ) Non-radial spondyloarthritis - absence of radiographic sacroiliitis but inflammation on MRI of the SI joints is frequently visible Axial SpA mostly affects the spine particularly the sacroiliac joint. Often misdiagnosed as mechanical low back pain

Peripheral SpA -Psoriatic arthritis Reactive arthritis○ following GI or urinary infections○ for e.g Campylobacter , Chlamydia , Salmonella , Shigella , Yersinia Enteropathic arthritis ie associated with comorbid inflammatory bowel disease. Often thought as unrelated joint or tendon problem and misdiagnosed as problems can move around between joints

NICE guideline - Spondyloarthritis in over 16s : diagnosis and management 2017 is an important document which draws attention about SpA's and provides clear advice on when to suspect and what should be done. This guideline should help with early recognition and treatment.

How common -It is difficult to determine the prevalence of SpAs due to factors as○ methodological differences between studies○ case definition used to classify disease and prevalence of HLA-B27 in the population○ heterogeneity due...