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The skeleton is subdivided into two major divisions—the axial skeleton and the appendicular skeleton. The axial skeleton forms the vertical, central axis of the body. It includes all of the bones of the head, neck, chest, and back. It protects the brain, spinal cord, heart, and lungs. It also serves as the attachment site for muscles that move the head, neck, and back and for muscles that act across the shoulder and hip joints to move their corresponding limbs.
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In addition to being held together by the intervertebral discs, adjacent vertebrae also articulate with each other at synovial joints formed between the superior and inferior articular processes called zygapophysial joints (facet joints). These are plane joints that provide for only limited motions between the vertebrae. The orientation of the articular processes at these joints varies in different regions of the vertebral column and serves to determine the types of motions available in each...
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Functional Classification of Joints
The functional classification of joints is determined by the amount of mobility between the adjacent bones. Joints are functionally classified as a synarthrosis or immobile joint, an amphiarthrosis or slightly moveable joint, or as a diarthrosis, a freely moveable joint. Fibrous and cartilaginous joints can be functionally classified as either synarthroses  or amphiarthroses, whereas all synovial joints are classified as diarthroses.
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Eccentric axial loading occurs when an axial load is applied away from the centroidal axis of a structural member. This scenario is common in engineering, where structural elements may not be directly aligned due to various design or functional requirements.
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The adult human body usually has 206 bones, and except for the hyoid bone in the neck, each bone is connected to at least one other bone. Joints are the location where bones come together. Many joints allow for movement between the bones. At these joints, the articulating surfaces of the adjacent bones can move smoothly against each other. However, the bones of other joints may be joined by connective tissue or cartilage. These joints are designed for stability and provide little or no...
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Optimizing the use of patient-reported outcome measures in axial spondyloarthritis: a mixed-methods study from the QUESTIONAX Project.

Seminars in arthritis and rheumatism·2026
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Instrument selection for the assessment of peripheral arthritis in axial and peripheral spondyloarthritis: an ASAS project.

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Measurement properties of instruments assessing peripheral arthritis disease activity in spondyloarthritis: a systematic literature review.

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Comparison of the established ASAS definition and preliminary proposed data-driven cut-offs for inflammatory and structural MRI lesions in the sacroiliac joints for eligibility of patients with nonradiographic axial spondyloarthritis in clinical trials.

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Axial spondyloarthritis.

Victoria Navarro-Compán1, Alexandre Sepriano2, Dafne Capelusnik3

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Axial spondyloarthritis is a chronic inflammatory condition causing back pain and stiffness. Early diagnosis and management, including NSAIDs and advanced therapies, are crucial to prevent irreversible damage and improve patient quality of life.

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Area of Science:

  • Rheumatology and Immunology
  • Musculoskeletal Diseases

Background:

  • Axial spondyloarthritis (AxSpA) is a chronic inflammatory disease affecting the sacroiliac joints and spine.
  • Initial symptoms include back pain and stiffness, but peripheral and extra-musculoskeletal manifestations are also common.
  • Diagnosis is challenging, requiring a combination of clinical, laboratory (HLA-B27), and imaging findings.

Purpose of the Study:

  • To provide an overview of axial spondyloarthritis, including its manifestations, diagnostic challenges, and current management strategies.
  • To highlight the importance of timely diagnosis and persistent disease activity assessment for preventing structural damage.
  • To discuss future directions in improving disease awareness, diagnosis, and patient outcomes.

Main Methods:

  • Review of clinical patterns, laboratory markers (HLA-B27), and imaging findings (radiographs, MRI) for diagnosis.
  • Utilization of the Assessment in SpondyloArthritis international Society (ASAS) classification criteria.
  • Assessment of disease activity using tools like the Axial Spondyloarthritis Disease Activity Score (ASDAS).

Main Results:

  • AxSpA presents with diverse symptoms, necessitating a comprehensive diagnostic approach.
  • Persistent disease activity correlates with irreversible structural damage and functional impairment.
  • Current management includes non-pharmacological interventions and pharmacological therapies, with NSAIDs as first-line and biologics/JAK inhibitors as second-line.

Conclusions:

  • Early and accurate diagnosis of AxSpA is critical for effective management.
  • Optimizing disease management strategies is essential to mitigate long-term complications.
  • Future advancements aim to enhance disease awareness, diagnostic capabilities, and patient quality of life.