RT Book, Section
A1 Liew, Jean W.
A1 Gensler, Lianne S.
A2 Stone, John H.
SR Print(0)
ID 1180196165
T1 Axial Spondyloarthritis & Arthritis Associated with Inflammatory Bowel Disease
T2 Current Diagnosis & Treatment: Rheumatology, 4e
YR 2021
FD 2021
PB McGraw Hill
PP New York, NY
SN 9781259644641
LK accessmedicine.mhmedical.com/content.aspx?aid=1180196165
RD 2024/04/19
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.