Evidenzbasierte Empfehlung zur Diagnostik und Therapie der axialen Spondyloarthritis

Abstract

The clinical course of axial spondyloarthritis (SpA) is variable and characterized by chronic back pain and extraspinal manifestations, such as asymmetrical arthritis, dactylitis and enthesitis. Extra-articular manifestations in the eyes (anterior uveitis), skin (psoriasis) and intestines (chronic inflammatory bowel disease) are also frequent manifestations in patients with SpA. Due to the heterogeneity of disease manifestations and the partial concentration on structural alterations in the sacroiliac joints visible in X‑ray images, the diagnosis is often delayed for many years. An important step in the direction of improved early recognition of axial SpA was establishment of the Assessment of SpondyloArthritis International Society (ASAS) classification criteria published in 2009, which focused on the initally deep-seated back pain and chronicity in relatively young patients as well as the importance of magnetic resonance imaging and HLA B 27 determination in the early stages of the disease. In order to achieve the foundations for an effective and timely therapy of affected patients, in 2014 on the initiative of the German Society of Rheumatology, S3 guidelines on axial SpA including Bechterew's disease and early forms were formulated in cooperation with other specialist societies. This article gives an overview of the contents of the S3 guidelines on axial SpA.

Reliability of an adapted core strength endurance test battery in individuals with axial spondylarthritis

“…Eligible individuals also had to be capable of getting down onto the floor and lying in the prone, supine, and side positions. Exclusion criteria were heart diseases of class three or four, according to the New York Heart Association [22], diagnosed osteoporosis of grade two or more [23], or surgical spondylodesis performed on the entire lumbar spine.…”

Labordiagnostik bei entzündlichen Gelenkerkrankungen

“…So werden für die ankylosierende Spondylitis erhöhte CRP-Werte bei ca. 50 % der Patienten gefunden [6,7]. Diese Parameter sind somit relativ schwache Diagnose-Bausteine, gleichwohl zählt die CRP-Erhöhung zu den Spondyloarthritis-Zeichen der ASAS-Klassifikationskriterien [8] sowie zu den Prädiktoren radiologischer Progression [9].…”