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By Apostolos Kontzias, MD, Assistant Professor of Medicine and Director, Autoinflammatory Clinic, Cleveland Clinic Foundation

Spondyloarthritis (also called spondyloarthropathy or spondyloarthritides) is a term used to describe a group of connective tissue diseases that cause prominent joint inflammation. These diseases affect the joints and spine and share certain characteristics. For example, they may cause back pain, inflammation of the eye (uveitis), digestive symptoms, and rashes. Some are strongly associated with the HLA-B27 gene. Because they cause many of the same problems and share genetic characteristics, some experts think these disorders share similar causes and ways of causing symptoms.

Spondyloarthritis causes joint inflammation, similar to rheumatoid arthritis. However, in contrast to rheumatoid arthritis, rheumatoid factor (see Blood tests) is negative in spondyloarthritis (hence, these disorders are also called the seronegative spondyloarthropathies). These disorders include

Spondyloarthritis also can develop in association with digestive conditions (sometimes called enteropathic arthritis), such as inflammatory bowel disease, intestinal bypass surgery, or Whipple disease.

Juvenile-onset spondyloarthritis affects the lower extremities, often affects joints on opposite sides of the body to different degrees, and begins most commonly in boys aged 7 to 16.

Spondyloarthritis can also develop in people with no characteristics of other specific spondyloarthritis (undifferentiated spondyloarthritis). Treatment of undifferentiated spondyloarthritis is similar to treatment of reactive arthritis. The disease-modifying antirheumatic drugs (DMARDs) methotrexate and sulfasalazine may help relieve symptoms of spondyloarthritis. Sometimes tumor necrosis factor inhibitors or other biologic agents may be needed.

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