Treatment measures include pharmacologic, physical therapy, and surgical.
The spondyloarthropathies are chronic inflammatory diseases that most commonly involve the SI joints and the axial skeleton, with hip and shoulder joints less frequently affected.
Other clinical manifestations include peripheral arthritis, enthesitis, and extra-articular organ involvement.
AS is the prototype of the spondyloarthropathies, a family of related disorders that also includes reactive arthritis (Re A), psoriatic arthritis (Ps A), spondyloarthropathy associated with inflammatory bowel disease (IBD), undifferentiated spondyloarthropathy (USp A), and, possibly, Whipple disease and Behçet disease (see the image below).
Pulmonary fibrosis is generally an asymptomatic incidental radiographic finding.
Early diagnosis is important because early medical and physical therapy may improve functional outcome.
As with any chronic disease, patient education is vital to familiarize the patient with the symptoms, course, and treatment of the disease.
Early radiographic signs of enthesitis include squaring of the vertebral bodies caused by erosions of the superior and inferior margins of these bodies, resulting in loss of the normal concave contour of the bodies’ anterior surface.
The inflammatory lesions at vertebral entheses may result in sclerosis of the superior and inferior margins of the vertebral bodies, called shiny corners (Romanus lesion).