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Overview of the clinical manifestations and classification of spondyloarthritis

David T Yu, MD
Astrid van Tubergen, MD, PhD
Section Editor
Joachim Sieper, MD
Deputy Editor
Paul L Romain, MD


The term spondyloarthritis (SpA) is used for a family of disorders, including ankylosing spondylitis (AS), non-radiographic axial spondyloarthritis (nr-axSpA), forms of arthritis associated with psoriasis and with inflammatory bowel diseases, and other conditions. The different forms of SpA share a group of clinical features; the most distinguishing features are inflammation of axial joints (especially the sacroiliac [SI] joints), asymmetric oligoarthritis (especially of the lower extremities), dactylitis (sausage digits), and enthesitis (inflammation at sites of ligamentous or tendon attachment to bone).

Additional features include skin and genital lesions, eye and bowel inflammation, an association with preceding or ongoing infectious disorders, positive family history, elevated acute phase reactants, and a strong association with the human leukocyte antigen (HLA)-B27 [1]. Other terms that have been used for this family of arthritis are spondyloarthritides, spondyloarthropathy, and spondyloarthropathies.

An overview of the clinical manifestations and the classification of SpA in adults will be presented here. The clinical manifestations and diagnosis of AS and nr-axSpA, psoriatic arthritis, reactive arthritis (formerly called Reiter’s syndrome), and SpA in children are discussed separately, as is an overview of peripheral SpA. (See "Clinical manifestations of axial spondyloarthritis (ankylosing spondylitis and nonradiographic axial spondyloarthritis) in adults" and "Diagnosis and differential diagnosis of axial spondyloarthritis (ankylosing spondylitis and nonradiographic axial spondyloarthritis) in adults" and "Clinical manifestations and diagnosis of psoriatic arthritis" and "Spondyloarthritis in children" and "Reactive arthritis" and "Clinical manifestations and diagnosis of peripheral spondyloarthritis in adults".)


The spondyloarthritis (SpA) family consists of the following members, which can be classified further according to the distribution of joint involvement as being predominantly axial (axial SpA) or peripheral (peripheral SpA):

Ankylosing spondylitis (AS) (see "Clinical manifestations of axial spondyloarthritis (ankylosing spondylitis and nonradiographic axial spondyloarthritis) in adults")

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Literature review current through: Nov 2017. | This topic last updated: Mar 22, 2017.
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