Abstract
Spondyloarthritis (SpA) is a group that includes a wide spectrum of clinically similar diseases manifested by oligoarticular arthritis and axial or peripheral ankylosis. Although axial SpA is predominant in Caucasians and adult-onset patients, juvenile-onset and Latin American patients are characterized by severe peripheral arthritis and particularly foot involvement. The peripheral involvement of SpA can vary from tarsal arthritis to the most severe form named ankylosing tarsitis (AT). Although the cause and etiopathogenesis of axSpA are often studied, the specific characteristics of pSpA are unknown. Several animal models of SpA develop initial tarsitis and foot ankylosis as the main signs, emphasizing the role of foot inflammation in the overall SpA spectrum. In this review, we attempt to highlight the clinical characteristics of foot involvement in SpA and update the knowledge regarding its pathogenesis, focusing on animal models and the role of mechanical forces in inflammation.
Highlights
Spondyloarthritis (SpA) is a group of chronic inflammatory diseases of the entheses and the synovial membrane of the joints, tendons, and bursae that affects the spine, the sacroiliac joint, and peripheral sites [1, 2]
Around the age of 8 years starts the inflammatory stage of the disease, which is mostly characterized by arthritis, enthesitis, and axial involvement; this is the disease “continuum” stage, which merged with tarsal ankylosis in the adolescent years or sacroiliac and spinal ankylosis in early adulthood
Arthritis and enthesitis can be induced in the absence of alpha-beta or gamma-delta T cells development of SpA, and animal models have provided much of the current information, several studies on human samples reveal a complex immune network that modulates the response to risk factors and enhancing elements toward the onset of the disease (Figure 5)
Summary
Spondyloarthritis (SpA) is a group that includes a wide spectrum of clinically similar diseases manifested by oligoarticular arthritis and axial or peripheral ankylosis. Axial SpA is predominant in Caucasians and adult-onset patients, juvenile-onset and Latin American patients are characterized by severe peripheral arthritis and foot involvement. The peripheral involvement of SpA can vary from tarsal arthritis to the most severe form named ankylosing tarsitis (AT). Several animal models of SpA develop initial tarsitis and foot ankylosis as the main signs, emphasizing the role of foot inflammation in the overall SpA spectrum. We attempt to highlight the clinical characteristics of foot involvement in SpA and update the knowledge regarding its pathogenesis, focusing on animal models and the role of mechanical forces in inflammation
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