TY - CHAP M1 - Book, Section TI - Axial Spondyloarthritis & Arthritis Associated with Inflammatory Bowel Disease A1 - Liew, Jean W. A1 - Gensler, Lianne S. A2 - Stone, John H. Y1 - 2021 N1 - T2 - Current Diagnosis & Treatment: Rheumatology, 4e AB - ESSENTIALS OF DIAGNOSISThe hallmark feature of axial spondyloarthritis (axSpA) is inflammatory back pain (IBP), especially with onset younger than 45 years of age. IBP features include worsening with rest, improvement with activity or exercise, nighttime awakening due to pain and/or stiffness (especially in the second part of the night), and response to nonsteroidal anti-inflammatory drugs (NSAIDs).Other SpA features include enthesitis, peripheral arthritis, dactylitis, acute anterior uveitis (AAU), psoriasis, and inflammatory bowel disease (IBD).Among Caucasian individuals with ankylosing spondylitis (AS) (radiographic axSpA), 85–95% are positive for HLA-B27. However, among those who are Black, HLA-B27 is only present in 50%.Damage to the bilateral sacroiliac (SI) joints is seen on conventional radiographs, although this finding may only develop years after initial symptom onset. Acute inflammation (bone marrow edema) and structural lesions (erosions, ankylosis, and subchondral fat [fat metaplasia]) may be seen earlier on magnetic resonance imaging (MRI) of the SI joints. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/04/20 UR - accessmedicine.mhmedical.com/content.aspx?aid=1180196165 ER -