Spondyloarthritis

The Rheumatology Program at UT Southwestern Medical Center is widely recognized as one of the nation’s leading clinical and research centers for rheumatic diseases such as spondyloarthritis.

Combining expert and compassionate care with state-of-the-art medical resources, we offer accurate diagnostic services and effective treatments to improve the quality of our patients’ lives.

Experienced Care for Spondyloarthritis

Spondyloarthritis is a group of arthritis conditions that affects bones in the spine (vertebrae) and nearby joints, causing pain and inflammation. Spondyloarthritis also involves locations where bones connect to muscles, ligaments, and tendons.

Our rheumatologists and other doctors are researchers who bring the most advanced therapeutic techniques available from the lab to the bedside to treat all forms of spondyloarthritis. We’re at the forefront in discovering immune system abnormalities to develop the newest treatments.

Types of Spondyloarthritis

The various types of spondyloarthritis affect different areas of the body:

• Ankylosing spondylitis predominantly affects the spine, pelvis, and hips with pain, inflammation, and bone damage
• Enteropathic arthritis develops in the lower back, pelvis, legs, and/or arms of people who have an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
• Psoriatic arthritis affects some people with a skin condition called psoriasis. It can develop anywhere in the body but often affects the hand and leg joints.
• Reactive arthritis, formerly known as Reiter’s syndrome, can develop after an infection in the urinary tract or intestines and usually affects the knees, ankles, and feet.
• Undifferentiated spondyloarthritis produces symptoms of more than one type and sometimes develops into a specific type of the disease.

Causes and Risk Factors of Spondyloarthritis

The specific causes of most types of spondyloarthritis are unknown, although medical experts have found genetic factors. People who have a gene known as HLA-B27 are at a higher risk of developing ankylosing spondylitis, enteropathic arthritis, psoriatic arthritis, and reactive arthritis. However, not everyone with this gene goes on to develop the disease. UT Southwestern’s Dr. Joel Taurog has been a world leader in characterizing the role of HLA-B27 in spondyloarthritis. 

Certain factors can increase the risk of spondyloarthritis; however, not everyone who has these risk factors develops the condition, and some people without risk factors can develop it.

Risk factors vary by type of spondyloarthritis and include:

• Certain bacterial infections, such as salmonella or sexually transmitted bacteria
  
• Family history
  
• Male gender
  
• Psoriasis, for psoriatic arthritis
  
• Inflammatory bowel disease, for enteropathic arthritis 
  

Symptoms of Spondyloarthritis

Signs and symptoms vary by type of spondyloarthritis. Some common symptoms include:

• Pain, stiffness, and swelling in the lower back, hips, shoulders, knees, elbows, and areas where tendons and ligaments meet bone, especially after long periods of sitting or standing
• Fever
• Fatigue
• Skin rash (psoriasis)
• Inflammation in the eyes or intestines

Diagnosing Spondyloarthritis

Our rheumatologists (specialists in diseases that affect joints, bones, muscles, and the immune system) conduct a thorough evaluation, which includes a:

• Physical exam
• Discussion of personal and family medical history
• Discussion of symptoms

We might recommend one or more tests, such as:

• X-ray to check for signs of damage in joints and bones, particularly in the pelvis, lower back, and feet
  
• Magnetic resonance imaging (MRI) scan to provide detailed images of inflammatory changes in bones, tendons, and ligaments
  
• Blood test to detect the presence of the HLA-B27 gene
  
• Tests of fluid taken from an affected joint to check for infection or signs of inflammation
  

Treatment for Spondyloarthritis

Although spondyloarthritis currently has no cure, treatment helps relieve symptoms and prevent progression. At UT Southwestern, our rheumatologists offer several treatment options:

• Pain relievers known as NSAIDs to reduce joint pain, stiffness, and swelling
• Disease-modifying antirheumatic drugs (DMARDs) to slow the progression of arthritis and help prevent permanent joint damage
• Biologic medications that block specific pathways of inflammation, such as Humira and Enbrel, or the newer Cosentyx and Taltz
  
• Corticosteroid injections into a joint for longer-term pain relief
• Physical therapy to improve strength and flexibility
  
• Arthroscopic surgery using minimally invasive techniques to repair joint damage
  
• Joint replacement surgery for patients with severe joint damage