Seronegative spondyloarthritis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

"Seronegative" refers to the fact that these diseases are negative for Rheumatoid factor and CCP in the serum.

Classsiication

Algorithm showing classification of seronegative spondyloarthritis

Seronegative Spondyloarthritis (SpA)

Axial SpA including Ankylosing spondylitis

Peripheral SpA

Psoriatic arthritis

Reactive arthritis

Inflammatory bowel disease related arthritis

Juvenile spondyloarthritis

Classification Criteria

The Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (axial SpA) include:

• Patient with back pain ≥ 3 months and age of onset <45 years should fulfill either of the two criteria:
  1. Sacroiliitis on imaging^* plus ≥ 1 feature of SpA^**
  2. HLA-B27 plus ≥ 2 feature of SpA^**

^*Sacroiliitis on imaging:

• Active (acute) inflammation on MRI highly suggestive of sacroiliitis associated with SpA

OR

• Definite radiographic sacroillitis accorging to modified New York criteria

^**SpA features:

• Inflammatroy back pain
• Arthritis
• Enthesotos (heel)
• Uveitis
• Dactylitis
• Psoriasis
• Crohn's disease or ulcerative colitis
• Good response to NSAIDs
• Family history for SpA
• HLA-B27
• Elevated CRP

Diagnosis

These diseases has following conditions in common:

• They are in relation to HLA-B27
• sacroiliitis and spondylitis are present in them.
• familial aggregation occurs
• Overlap is likely in them
• rheumatoid factor is not present