Abstract
The spondyloarthritides encompass various clinical manifestations. The hallmark of the spondyloarthropathies is inflammatory axial and sacroiliac (buttock) pain. Associated findings include peripheral arthritis, uveitis, conjunctivitis, enthesitis, and psoriasis. Human leukocyte antigen (HLA) B27 is positive in a majority of patients. Radiographic abnormalities appear first on vertebral column/sacroiliac magnetic resonance imaging (MRI) and many years later on radiography, which makes the diagnosis challenging. Of course, rheumatoid factor is negative – hence the term seronegative arthritis. Other clinical clues that help identify this disease’s spectrum are a family history of ankylosing spondylitis (AS), psoriasis, or inflammatory bowel disease (IBD); intestinal or genitourinary symptoms; or the presence of psoriasis. All this heterogeneity makes an early diagnosis difficult.
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