关键词: Ankylosing spondylitis Dactylitis Enthesitis Magnetic resonance imaging Management

Mesh : Back Pain / diagnosis etiology therapy Clinical Decision-Making / methods Diagnosis, Differential Evidence-Based Medicine / standards Germany Humans Magnetic Resonance Imaging / standards Outcome Assessment, Health Care / standards Practice Guidelines as Topic Rheumatology / standards Societies, Medical / standards Spondylarthritis / complications diagnosis therapy Treatment Outcome

来  源:   DOI:10.1007/s00393-016-0232-x

Abstract:
The clinical course of axial spondyloarthritis (SpA) is variable and characterized by chronic back pain and extraspinal manifestations, such as asymmetrical arthritis, dactylitis and enthesitis. Extra-articular manifestations in the eyes (anterior uveitis), skin (psoriasis) and intestines (chronic inflammatory bowel disease) are also frequent manifestations in patients with SpA. Due to the heterogeneity of disease manifestations and the partial concentration on structural alterations in the sacroiliac joints visible in X‑ray images, the diagnosis is often delayed for many years. An important step in the direction of improved early recognition of axial SpA was establishment of the Assessment of SpondyloArthritis International Society (ASAS) classification criteria published in 2009, which focused on the initally deep-seated back pain and chronicity in relatively young patients as well as the importance of magnetic resonance imaging and HLA B 27 determination in the early stages of the disease. In order to achieve the foundations for an effective and timely therapy of affected patients, in 2014 on the initiative of the German Society of Rheumatology, S3 guidelines on axial SpA including Bechterew\'s disease and early forms were formulated in cooperation with other specialist societies. This article gives an overview of the contents of the S3 guidelines on axial SpA.
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