Spondyloarthritis, designated under the acronym SpA, (formerly called spondyloarthropathy) are inflammatory rheumatisms sharing common characteristics such as genetic factors and the privileged attack of the enthesis.
As the name suggests (spondylos = vertebra), the most common damage is the so-called axial form (affecting the spine, the sacroiliac joints, the anterior chest wall, etc.) but there are also peripheral forms, type of arthritis, oligoarthritis or polyarthritis (to be differentiated from rheumatoid arthritis).
This family includes ankylosing spondylitis, rheumatism associated with inflammatory bowel disease (including Crohn's disease and ulcerative colitis), psoriatic arthritis, reactive arthritis, juvenile spondyloarthropathy, SAPHO syndrome. Damage that does not correspond to any of these diseases is called undifferentiated spondyloarthropathy. The bacterium Ruminococcus gnavus would have a role in inflammation.
The diagnosis of rheumatoid spondylitis is too late. Patients wait an average of 6 years for it to be inserted. The general practitioner must determine whether the lower back pain has an inflammatory or mechanical origin. To do this, he will ask you several questions (family history of ankylosing spondylitis, psoriasis, inflammatory bowel disease, etc.). The main ones are:
Is your back stiff in the morning for at least 30 minutes?
Is your back improved by exercise but not by rest?
Does your back pain only wake you up during the second part of the night?
Do you have alternating right and left (“rocking”) buttock pain?
A score greater than or equal to 6 indicates the presence of spondyloarthritis (sensitivity 85%, specificity 90%).