Hip and Shoulder Involvement and Their Management in Axial Spondyloarthritis: a Current Review
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SPONDYLOARTHRITIS (M KHAN, SECTION EDITOR)
Hip and Shoulder Involvement and Their Management in Axial Spondyloarthritis: a Current Review Clementina López-Medina 1,2,3,4 & M. Carmen Castro-Villegas 1,2,3 & Eduardo Collantes-Estévez 1,2,3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Hip and shoulder disease can occur in patients with spondyloarthritis (SpA). While hip involvement has been widely assessed in axial SpA patients, studies in the overall SpA population as well as studies focused on shoulder involvement are scarce. Here, we review the most recent studies on the epidemiology, evaluation, and treatment of root joint involvement in SpA patients. Recent Findings Radiological hip involvement can affect up to 25% of patients with SpA, reflecting more severe disease and associated with functional impairment. Shoulder involvement in SpA patients is characterized by cuff tendinitis and enthesitis, while primary glenohumeral joint involvement is rare. Anti-tumor necrosis factor (anti-TNF) treatment in SpA patients seems to have an effect on hip arthritis, showing a change in trend in the frequency of hip replacement in this population. Summary The majority of studies evaluating hip involvement have focused on axial SpA patients, but further studies evaluating root joint involvement in the overall SpA population are needed. Anti-TNF therapy should be considered in patients with hip involvement, and root joint involvement should be assessed routinely in clinical practice. Keywords Spondyloarthritis . Hip . Shoulder . Epidemiology . Imaging . Outcomes
Introduction Spondyloarthritis (SpA) is a group of inflammatory rheumatic disorders that mainly affect the axial skeleton and sacroiliac joints. Classically, SpA has been classified into several subtypes, such as ankylosing spondylitis (AS), psoriatic arthritis (PsA), inflammatory bowel disease (IBD)-associated SpA, This article is part of the Topical Collection on Spondyloarthritis * Eduardo Collantes-Estévez [email protected] Clementina López-Medina [email protected] M. Carmen Castro-Villegas [email protected] 1
Rheumatology Department, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba, Spain
2
Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
3
Medicine Department, University of Cordoba, Cordoba, Spain
4
Rheumatology Department, Cochin Hospital, Paris, France
reactive arthritis (ReA) and undifferentiated SpA (u-SpA) [1]. In 2011, the Assessment of Spondyloarthritis International Society (ASAS) developed a new set of criteria and introduced the concept of axial SpA (axSpA) (AS is the prototype of axSpA) and peripheral SpA (pSpA), depending on the presence of predominantly axial or predominantly peripheral involvement, respectively [2]. Arthritis is the most common peripheral feature in SpA and is commonly located in the lower limbs [3]. Peripheral joint involvement is more frequent among patients with pSpA [4]; however, root joint involvement, s
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