Feature Article

Update on spondyloarthritis

Mark Reed, Lionel Schachna



Differentiating spondyloarthritides from more common mechanical back disorders is the major challenge in general practice.

Key Points

  • Spondyloarthritis occurs in 2 to 3% of the population and can cause significant long term disability.
  • Early diagnosis of spondyloarthritis is critical in the era of effective biological therapies.
  • A detailed but focused history is essential in identifying early spondyloarthritis, when examination findings and radiographs may be normal.
  • Traditional disease modifying antirheumatic drugs (DMARDs) are less effective in spondyloarthritis than in rheumatoid arthritis.
  • Tumour necrosis factor (TNF) inhibitors have revolutionised the management of spondyloarthritis.