Spondyloarthritides: Ankylosing Spondylitis, Psoriatic Arthritis, and Reactive Arthritis

The concept of spondyloarthritis (SpA) goes back several decades for this partly heterogeneous group of diseases. The term SpA traditionally covers ankylosing spondylitis, reactive arthritis, arthritis/spondylitis associated with psoriasis, and arthritis/spondylitis associated with inflammatory bowel disease. Today the spectrum of SpA has been broadened based on the introduction of new classification criteria for SpA, especially those with predominant axial involvement, which are differentiated from the more peripheral SpA. Thus early and abortive forms have been integrated. The main link between the SpA is the association with HLA-B27 and other genes, a similar pattern of peripheral joint involvement with asymmetrical, often oligoarticular, arthritis, and/or the potential manifestations of sacroiliitis and/or spondylitis, enthesitis, dacytilitis, and/or uveitis. Involvement of the heart occurs comparatively rarely, but at least in part with a unique clinical appearance that concentrates on the aortic root and the atrioventricular conduction system. In addition, the significance of classical risk factors for the development of cardiovascular disease is potentiated by chronic inflammation in these patients.