Das Konzept der nicht-röntgenologischen axialen Spondyloarthritis

Zusammenfassung

Der Begriff Spondyloarthritis (SpA) umfasst eine Gruppe von rheumatischen Erkrankungen, die neben einer Entzündung des Achsenskelettes (Sakroiliitis, Spondylitis) auch durch eine Entzündung peripherer Gelenke (Arthritis) und Sehnenansätze (Enthesitis) charakterisiert ist. Die SpA wird heute je nach im Vordergrund stehender klinischer Symptomatik in eine prädominant axiale und in eine prädominant periphere Form eingeteilt. Bei der axialen Form unterscheidet man die ankylosierende Spondylitis (AS), die durch strukturelle Veränderungen in den Sakroiliakalgelenken im konventionellen Röntgenbild charakterisiert ist, von der sogenannten nicht-röntgenologischen Form, bei der definitionsgemäß keine derartigen Veränderungen vorliegen. In diesem Übersichtsartikel werden neben den klinischen Charakteristika vor allem die Diagnostik und Therapie der axialen SpA inklusive der nicht-röntgenologischen axialen SpA im Vergleich zur klassischen AS dargestellt.

Abstract

The characteristic features of spondyloarthritis are inflammation of the axial skeleton (sacroiliitis, spondylitis) and inflammation of peripheral joints (arthritis) and entheses (enthesitis). According to the leading clinical symptom, SpA can be differentiated in either a predominant axial or a peripheral form. Axial SpA is further subdivided in the classical ankylosing spondylitis and non-radiographic axial SpA (nr-axSpA). These subsets are differentiated by the presence or absence of structural changes on conventional X-rays of the sacroiliac joints. Here we describe the clinical symptoms, the diagnosis and therapy for patients with axial SpA including patients with nr-axSpA.

Schlüsselwörter

Spondyloarthritis - Management - Empfehlungen

Key words

spondyloarthritis - management - recommendations

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