[Seronegative spondyloarthropathies]

Seronegative spondyloarthropathies are characterized by bilateral or unilateral sacroiliitis, spondylitis, peripheral arthritides or extraarticular manifestations. The spondyloarthropathies are associated with a positive HLA-B27 status. Genetic factors, repetitive biomechanical stress and the immune response to bacterial products lead to the inflammatory changes at typical anatomical sites. Diseases classified as spondyloarthropathies include ankylosing spondylitis, reactive arthritis, psoriatic arthritis, juvenile spondyloarthropathy and inflammatory bowel disease associated with spondylitis. The SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome is also considered a member of the spondyloarthropathy family. An otherwise unclassified HLA-B27-linked peripheral arthritis is often considered an undifferentiated spondyloarthropathy. Treatment consists of physical therapy including patient education, non-steroidal anti-inflammatory drugs and disease modifying anti-rheumatic drugs.