What are the spondyloarthropathies?

When Bernard Connor published the first anatomical description on the skeletal abnormalities found in established Ankylosing Spondylitis (AS) in 1691 ( Fig. 1 ), he could hardly have anticipated the importance of his findings and the depth of the clinical and basic science research which has followed his observations especially in recent years. This book focuses on two members of the spondyloarthropathy (SpA) family, AS and Psoriatic Arthritis (PsA), and attempts to summarise and bring up-to-date the key developments in the field. The SpA family, which also includes juvenile spondyloarthritis, inflammatory bowel disease associated-arthritis, and reactive arthritis, are grouped together because they share some clinical, imaging and genetic features. Spinal and sacroiliac joint involvement, predilection for large joint, lower limb involvement, psoriasis and acute anterior uveitis all have variable expression with some families displaying a number of different clinical phenotypes. Imaging studies again highlight sacroiliac joint and spinal involvement with peripheral joints displaying a mixed pattern of bone resorption and new bone formation. Finally genetic studies have shown that all SpA members may be associated, though to a variable extent, with HLA-B27.