Spondyloarthritis, also referred to as spondylitis or SpA, diseases are currently grouped or classified in two main ways:
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Inflammation in the spine and/or pelvis causes inflammatory back pain. Inflammatory back pain usually starts gradually before the age of 45, tends to improve with activity but not rest, and occurs with stiffness in the morning that lasts at least 30 minutes.
Over time, this inflammation can lead to ankylosis -- new bone formation in the spine -- causing sections of the spine to fuse in a fixed, immobile position. AS can also cause inflammation, pain and stiffness in other areas of the body such as the shoulders, hips, ribs, heels, and other joints.
About Ankylosing Spondylitis
In addition to inflammatory back and/or joint pain, inflammation of the intestine, which includes the bowel, is a predominant feature of EnA. Symptoms may include chronic diarrhea, abdominal pain, weight loss, and/or blood in the stool. The most common types of inflammatory bowel diseases are Crohn’s, ulcerative colitis, and undifferentiated colitis.
About Enteropathic Arthritis
PsA frequently causes pain and swelling in the small joints of the hands and feet. Most people with PsA have a psoriasis skin rash. Some people have a “sausage digit” with a toe or finger that swells between the joints and around the joints. A portion of people with PsA also have pain and stiffness in the spine.
About Psoriatic Arthritis
An infection in the intestine or urinary tract usually occurs before inflammation in the joints. ReA can cause inflammation and pain in the joints, skin, eyes, bladder, genitals, and mucus membranes. ReA frequently follows a limited course, with symptoms typically subsiding in three to 12 months. The condition does have a tendency to recur, however, and some people with ReA will develop a chronic form of arthritis.
About Reactive Arthritis
People with USpA have symptoms and disease features consistent with spondyloarthritis, but their disease doesn’t fit into another category of SpA. For example, an adult may have iritis, heel pain (enthesitis), and knee swelling, WITHOUT back pain, psoriasis, a recent infection, or intestinal symptoms. This person’s combination of disease features suggests spondyloarthritis, but she doesn’t neatly fit into the categories of ankylosing spondylitis, psoriatic arthritis, reactive arthritis, juvenile spondyloarthritis, or enteropathic arthritis
About Undifferentiated Spondyloarthritis
Symptoms begin in childhood. JSpA can look like any other type of spondyloarthritis. Enthesitis, inflammation where tendons or ligaments meet bone, is often a dominant disease feature. Children and adolescents with JSpA tend to have more peripheral arthritis than adults with SpA. The arthritis typically involves joints in the lower extremities in an asymmetric fashion.
About Juvenile Spondyloarthritis
Axial SpA causes inflammation in the spine and/or pelvis that typically brings on inflammatory back pain. AxSpA is a broad category that includes people with and without characteristic inflammatory changes of the sacroiliac joints (joints linking the lowest part of the spine to the pelvis) seen on X-ray.
Doctors classify people as having a certain type of axial spondyloarthritis:
Almost all people with ankylosing spondylitis fit into the category of radiographic AxSpA. People with reactive arthritis, enteropathic arthritis, undifferentiated spondyloarthritis, and psoriatic arthritis may fit into the category of either radiographic AxSpA or nonradiographic AxSpA.
The Centers for Disease Control's NHANES study estimates that at least 2.7 million adults in the United States have axial spondyloarthritis.
Peripheral SpA commonly causes inflammation in joints and/or tendons outside the spine or sacroiliac joints. Commonly involved sites include joints in the hands, wrists, elbows, shoulders, knees, ankles, and feet. Inflammation of the tendons can occur in the fingers or toes (dactylitis) or where tendons and ligaments meet with bone (enthesitis). Almost all people with PsA fit into the pSpA category at some point in their disease. People with reactive arthritis, enteropathic arthritis, and undifferentiated arthritis may also fit into this category.
Many people with SpA have or will develop both axial SpA and peripheral SpA. Others will have only axial SpA or only peripheral SpA.
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