Spondyloarthropathy: types, causes, symptoms, treatment, prognosis
Spondyloarthropathy: a modern approach to the identification and treatment of pathology
This is a group of long-term, ongoing (chronic) inflammatory connective tissue diseases that occur in children (juvenile spondyloarthropathies) and in adults with a genetic predisposition.
The etiology of the disease presumably communicable.
Spondyloarthropathy is characterized by inflammation of the spine, peripheral and sacroiliac joints. The incidence – 5-12 patients per 1000 people.
Classification of the disease
Spondyloarthropathy is still the following:
- ankylosing spondylitis (Bechterew’s disease);
- psoriatic arthritis;
- reactive arthritis;
- Reiter syndrome;
- enteropeptidase arthritis (Whipple’s, nedifferentsirovannost nespetsificheskie colitis, Crohn’s disease);
Features varieties of the disease:
- Spondyloarthropathy seronegative ( ankylosing arthritis) is the cause of stiffness and pain in the lumbar spine, which after a while can move smoothly in the area blades. In severe cases it can cause deep lesions of the spine, causing permanent stiffness in the back. Also, the process can be involved the joints of the lower extremities. The children are the main symptoms of the knees, hips, heels, and after that work on the spine.
- Psoriatic spondyloarthropathy closely associated with the occurrence of psoriasis (the appearance of red and white scales on the skin), symptoms of which precede the symptoms of arthritis. On fingers of hands and feet may appear dimples, bulges, blisters, receiving a yellowish tint. Such education can give a sign that the inflammatory process has affected large joints. In addition, the patient may receive severe swelling of the fingers.
- Reactive arthritis is very similar to psoriasis, but the cause of its occurrence and the speed of propagation of the lesion is different. Reactive arthritis is caused by various infections and pathogenic microflora, which can penetrate into the spine after third-party diseases. If along with pain, swelling of the limbs and inflammation of the joints there is a skin lesion, it is Reiter’s disease.
- Enteropeptidase arthritis involves in the pathological process of inflammation of the spine and the intestinal wall. Symptoms can appear and disappear with varying intensity, but mostly, if the patient starts to hurt the stomach, there are signs of arthritis. The disease also affects the knee, elbow, ankle and hip joints.
Causes of pathology
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Scientists still have not figured out the cause of the disease, but many say that to blame genetic aspects, namely, the carriage of HLA-B27 identified in 80-90% of addressed patients.
Among the other causes of the disease, secrete urogenital infections (chlamydia, ureaplasmosis), gastrointestinal infections ( dysentery, salmonellosis, yersiniosis, campylobacteriosis), infection with Klebsiella.
Despite the fact that there are several types of spondyloarthropathies, their symptoms still have in common:
- fatigue of the body in a relaxed state, and in the context of increased activity;
- acute pain in the lumbar region, radiating to the buttocks;
- stiffness in lower back after sleep, passing during the day and after training.
In adults the disease is lesions of the spine when children suffer joints of the feet or hands.
Sometimes the disease may affect just 4 major joint (ankle, knee and others), cause inflammation of the iris of the eye and cause pain and tension in the neck.
Pathology is often the cause of inflammatory eye diseases, e.g. uveitis.
In some cases, the running stage can lead to loss of efficiency, since the deformation of the spine, the conversation about employment rights is not.
Chronic spondyloarthropathy may develop complications such as heart and lung disease.
What is the complexity of therapy?
Most often this disease has a light form and can for a long time not to be noticed by the patient.
To the doctor treated already in the presence of pain, but it is not the initial stage, or at successful coincidence of circumstances, when a third-party inspection could see the beginning of defeat.
Approach to treatment
Treatment is directed primarily at eliminating pain and discomfort, correction of posture, stretching the affected areas, to avoid deformation of the joints.
Inflammation is treated with nonsteroidal anti-inflammatory drugs, use of other drugs varies depending on the type of disease.
The main methods of treatment:
- Demedicalise. Patients are encouraged to maintain the posture when walking, wear the locking corsets and physical therapy. Popular swimming and exercises with straightening the spine and stretching the muscles. Patients with a particular activity, such as motorists, are advised to arrange their work place in such a way as not to hurt yourself even more.
- Medication. In the initial stages apply fast-acting drugs, such as NSAIDs. They are in for 48 hours to reduce pain in the back and joints, however, after this time, the pain can return again. Patients with peripheral arthritis and a high risk of the spread of inflammation prescribe medicines with long – sulfasalazine and methotrexate.
- Surgical. Operations are carried out depending on at what stage the disease is. Hip replacement is used in severe lesions, osteotomy is indicated for a severe kyphosis of the thoracic spine. Also, a number of operations directly associated with exposure to heart and lungs (prosthetic aortic valve, the installation of a pacemaker, and lung resection).
The prognosis is not good
Running stage can lead to loss of joint function, that is, to disability that appears after 20-40 years from the onset of the disease in patients with lesions of the hip joints.
Also the forecast can worsen inflammation of the cervical spine, leading to compression of the spinal cord, as well as the development of amyloid nephropathy, which can be avoided by using NSAIDs.
The use of treatment reduces the probability of death almost to zero, more than 90 percent of patients return to normal life.
So, spondyloarthropathy is a disease that must be treated in its early stages, but this time it does not bring discomfort to the patient, and therefore not detected in the examination.
To avoid irreversible complications, it is necessary to take preventive diagnosis, and in case of detection of the disease, to begin treatment.
If responsible for their health, then you can do a short course of medication and wearing orthopedic shoes to reduce pressure on the spine.
In more advanced cases have to resort to operations that will address not only the musculoskeletal system but also the heart, lungs, intestines.