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Author | Muhammad Asim Khan, MD


Update on the spondyloarthropathies

The spondyloarthropathies (SpA) are strongly associated with the HLA-B27 gene. The diagnosis is based primarily on clinical findings. Ankylosing spondylitis (AS) often involves the sacroiliac joints and spine. Psoriatic arthritis (PsA) occurs in up to about one third of patients with psoriasis. Reactive arthritis must be distinguished from other arthropathies. Arthritis occurs in about 30% of patients with inflammatory bowel disease. Undifferentiated SpA include sseveral related disorders. Radiographic evidence of sacroiliitisis a characteristic feature of AS. SpA management should include patient education and regular exercise. NSAIDs are the first line of treatment.The tumor necrosis factor α inhibitors are highly effective inpatients with active AS and in those with PsA that is unresponsive to conventional therapy. (J Musculoskel Med. 2008;25:31-40)