Management of Seronegative Spondyloarthropathies

The spondyloarthropathies are a group of rheumatic disorders that include ankylosing spondylitis (AS), reactive arthritis, psoriatic arthritis and enteropathic arthritis. These disorders are unified in their ability to manifest axial and/or peripheral inflammatory disease with the associated features of enthesitis, ocular inflammation, skin and nail changes, and mucosal lesions affecting the gastrointestinal tract or genitourinary tracts. Other common features include negative rheumatoid factor and association with HLA B27, which suggests a common or related aetiology. It may not always be possible to differentiate clearly between the various forms of spondyloarthropathies in early stages because these diseases generally share many common clinical features. The strength of the association with HLA B27 varies markedly not only among the various spondyloarthropathies but also among the various racial and ethnic groups. Their combined prevalence in the general population is estimated to be approximately 1%, which is comparable to that of rheumatoid arthritis.