CLINICAL MANIFESTATIONS OF SERONEGATIVE SPONDYLARTHROPATHIES

Seronegative spondylarthropathies include ankylosing spondylitis, Reit er's syndrome and reactive arthritis, psoriatic arthritis, arthritis a ssociated with ulcerative colitis and Crohn's disease, plus other form s which do not meet the criteria for definite categories and are calle d undifferentiated. Recently two sets of classification criteria have been proposed for the entire group including undifferentiated forms: t he European Spondylarthropathy Study Group and the Amor criteria. The prevalence of spondylarthropathies is directly correlated with the pre valence of the HLA-B27 antigen in the population. The highest prevalen ce of ankylosing spondylitis (4.5%) has been found in Canadian Haida I ndians, where 50% of the population is B27 positive. Among Europeans t he frequency of the B27 antigen in the general population ranges from 3 to 13% and the prevalence of ankylosing spondylitis is estimated to be 0.1-0.23%. Seronegative spondylarthropathies have common clinical a nd radiologic manifestations: inflammatory spinal pain, sacroiliitis, chest wall pain, peripheral arthritis, peripheral enthesitis, dactylit is, lesions of the lung apices, conjunctivitis, uveitis and aortic inc ompetence together with conduction disturbances. All of these may also occur in isolation. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.