Seronegative spondyloarthropathies and seronegative spondyloarthritis

Seronegative spondyloarthritis and spondyloarthropathies include many diseases, among them: Ankylosing spondylitis (spondylitis ankylosans), Psoriatic arthritis (arthritis psoriatica), SAPHO syndrome, arthritis associated with inflammatory bowel diseases – ulcerative colitis (colitis ulcerosa) and Crohn's disease (morbus Crohn); reactive arthritis (arthritis reactiva).

Psoriatic arthritis (arthritis psoriatica) belongs to the group of arthritides associated with skin psoriasis and other skin diseases. Its key features are:

– an inflammatory joint disease associated with skin psoriasis, though sometimes occurring without psoriasis
– 26% of patients with psoriasis have psoriatic arthritis
– involvement of the distal interphalangeal (DIP) joints – the end joints of the fingers – is characteristic
– dactylitis, enthesitis and tenosynovitis are common musculoskeletal signs accompanying psoriatic arthritis
– methotrexate and other disease-modifying drugs, as well as anti-TNF-α (anti-tumour necrosis factor alpha) agents, are effective for psoriasis and for manifestations in the spine and peripheral joints
– psoriatic arthritis must be treated because it destroys joints, reduces quality of life and causes metabolic syndrome and premature atherosclerosis.

Clinical factors that suggest psoriatic arthritis rather than another polyarthritis such as rheumatoid arthritis:
– asymmetric joint involvement
– absence of rheumatoid factor
– nail pitting, dents or nail dystrophy
– DIP joint involvement in the absence of osteoarthritis
– sausage digits (dactylitis) as part of tenosynovitis
– enthesitis or tendinitis of the Achilles tendon or plantar fascia
– psoriasis or psoriatic arthritis in the family
– X-ray signs in the spine and axial skeleton – sacroiliitis, paravertebral ossification, syndesmophytes
– peripheral X-ray signs such as erosive arthritis with relatively little periarticular osteopenia
– synovial biopsy showing increased vascularity and the presence of CD163+ macrophages, lymphocytes and neutrophils

At Faktor Zdravlje Polyclinic, our team of physiatrists and rheumatologists diagnoses, treats and monitors these conditions using modern treatments, medicines and procedures, together with top-quality physiotherapy. We also give second opinions when there are doubts or differing views on the treatment of psoriasis and psoriatic arthritis, or of seronegative spondyloarthritis and spondyloarthropathies.