Page 12 - SPONDYLOARTHRITIS IN COLOMBIA -

INTRODUCTION
Spondyloarthritis (SpA) comprises a heterogeneous group of distinct disorders including ankylosing spondylitis (AS), non-radiographic axial SpA, psoriatic arthritis, arthritis related to inflammatory bowel disease and reactive arthritis1. SpA is the second most prevalent form of chronic inflammatory arthritis, with an estimated prevalence of about 0.5-1.5%2. This condition is characterized by inflammation as well as structural damage3. The inflammatory process affects the axial skeleton and the sacroiliac joints (SI), the peripheral joints and may extend to organs such as eye, skin and gut.
Clinical presentation
The disease SpA usually starts in the second or third decade of life and has a male predominance. The clinical picture includes chronic back pain, peripheral arthritis, enthesitis and extra-articular manifestations such as uveitis, psoriasis and inflammatory bowel disease (IBD)4. Patients present with chronic back pain and morning stiffness of the lower back, but any part of the spine can be
involved. Inflammatory back pain (IBP) is typical. IBP has been clinically defined and different sets of criteria have been developed5. Arthritis and enthesitis are the most common peripheral manifestations that can occur at any time in the course of the disease. The joints may be swollen and/or painful and the lower limbs are most often affected, frequently in an asymmetrical fashion.
Comorbidities and risk factors
Comorbidities are frequently associated with inflammatory rheumatic diseases including SpA. In addition to the musculoskeletal manifestations for SpA and SpA-related extra-articular features, patients may also have an increased risk of cardiovascular events, arterial hypertension, metabolic syndrome, malignancies and infections6. An optimal detection and monitoring of comorbidities and
10