[轴性脊柱关节炎(axSpA)的诊断和分类--现状]。

Pub Date : 2024-04-01 DOI:10.1055/a-2251-6876
Jürgen Braun, Denis Poddubnyy
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引用次数: 0

摘要

轴性脊柱关节炎(axSpA)是一种以炎症性背痛(IBP)为典型特征的炎症性风湿病。轴性脊柱关节炎(axSpA)一词在很大程度上取代了长期使用的强直性脊柱炎(AS)一词。IBP 是由轴向骨骼的炎症引起的,骶髂关节 (SIJ) 最初尤其容易受到影响。在后期阶段,脊柱通常也会受到影响,新骨的形成会使脊柱的结构日趋完善。脊柱关节炎的整体概念还包括其他疾病表现,如葡萄膜炎、银屑病和结肠炎,以及合并症,如心血管疾病和骨质疏松症。在前者中,除了常规的X光检查外,磁共振成像(MRI)检测到的SIJ变化和HLA B27检测也首次发挥了作用。需要注意的是,这些并非诊断标准,因为它们并不存在。本文概述了诊断时应考虑的 10 个要点。
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[Diagnosis and classification of axial spondyloarthritis (axSpA) - the current status].
Axial spondyloarthritis (axSpA) is an inflammatory rheumatic disease typically characterized by inflammatory back pain (IBP). The term axSpA has largely replaced the long-used term ankylosing spondylitis (AS). IBP is caused by inflammation in the axial skeleton, with the sacroiliac joints (SIJ) being particularly frequently affected initially. The spine is usually added in later stages, which is then increasingly characterized structurally by the formation of new bone. The overall concept of spondyloarthritis includes other disease manifestations such as uveitis, psoriasis and colitis and comorbidities such as cardiovascular disease and osteoporosis.The ASAS classification criteria for axSpA, in place since 2009, have replaced the 1984 modified New York criteria. In the former, in addition to conventional X-rays, changes in the SIJ detected by magnetic resonance imaging (MRI) and also the detection of HLA B27 have, for the first time, played a role. It is important to note that these are not diagnostic criteria, as they do not exist. This paper outlines 10 points that should be considered when making a diagnosis.
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