Espondiloartritis, espondilitis anquilopoyética y síndrome SAPHO

Abstract

Spondyloarthritis is a heterogeneous group of chronic rheumatic diseases characterized by autoimmune/autoinflammatory involvement of different structures of the axial skeleton; entheses; peripheral joints; and extra-articular tissues such as the eyes, skin, and intestine. These conditions share a genetic basis, with HLA-B27 as a predisposing factor, in addition to immunological and environmental factors that contribute to their development. The clinical manifestations, which usually occur in flares, include inflammatory lumbar pain, peripheral arthritis, enthesitis, and extra-articular symptoms (uveitis, psoriasis, and inflammatory bowel disease). Its natural progression leads to the onset of tissue damage and characteristic osteogenesis. The diagnosis is based on a detailed clinical assessment supported by laboratory tests and imaging studies, notable among which is the use of magnetic resonance imaging for early detection, mainly in axial forms. Therapeutic strategies seek to reduce inflammation, alleviate symptoms, and prevent progression of structural damage, combining pharmacological treatments (NSAIDs, DMARDs, and biologics) with non-pharmacological interventions, including regular exercise. Delayed diagnosis and insufficient management represent significant challenges, underscoring the need for a multidisciplinary approach in the event of the onset of extra-musculoskeletal manifestations in order to improve patient health outcomes.