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Enthesophathy and arthritis of large joints of the lower extremities is more common than the characteristic early-morning back pain seen in adult AS. [13] Ankylosing tarsitis of the ankle is a common feature, as is the more classical findings of seronegative ANA and RF as well as presence of the HLA-B27 allele. [ 13 ]
The inflammatory mediators of RA including cytokines, growth factors, metalloproteinases destroy articular cartilage, subchondral bone, tendons and ligaments.Destructive synovitis leads to bone erosion and causes the ligaments of the spine to become too laxed (loose), eventually resulting in cervical spinal instability (loose neck bones).
In some, the x-ray findings may correspond to symptoms of back stiffness with flexion/extension or with mild back pain. [2] Back pain or stiffness may be worse in the morning. [4] Rarely, large anterior cervical spine osteophytes may affect the esophagus or the larynx and cause pain, difficulty swallowing [5] [6] or even dyspnea. [7]
Arthritis is a general medical term used to describe a disorder that affects joints. [2] Symptoms generally include joint pain and stiffness. [2] Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. [2] [3] In certain types of arthritis, other organs such as the skin are also affected. [5]
Dactylitis can occur in seronegative arthropathies, such as psoriatic arthritis and ankylosing spondylitis, and in sickle-cell disease as result of a vasoocclusive crisis with bone infarcts, and in infectious conditions including tuberculosis, syphilis, and leprosy. In reactive arthritis, sausage fingers occur due to synovitis. [2]
Psoriatic arthritis tends to appear about 10 years after the first signs of psoriasis. [3] For the majority of people, this is between the ages of 30 and 55, but the disease can also affect children. The onset of psoriatic arthritis symptoms before symptoms of skin psoriasis is more common in children than adults. [48]
Eye involvement typically occurs early in the course of reactive arthritis, and symptoms may come and go. Dactylitis, or "sausage digit", a diffuse swelling of a solitary finger or toe, is a distinctive feature of reactive arthritis and other peripheral spondylarthritides but can also be seen in polyarticular gout and sarcoidosis.
Spinal stenosis is an abnormal narrowing of the spinal canal or neural foramen that results in pressure on the spinal cord or nerve roots. [6] Symptoms may include pain, numbness, or weakness in the arms or legs. [1] Symptoms are typically gradual in onset and improve with leaning forward. [1]