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Caractéristiques communes

  • Enthésite (inflammation de l'insertion tendineuse), spondylite (inflammation du rachis), spondylarthrite (inflammation des articulations intervertébrales), sacro-ilite, arthrite asymétrique des articulations périphériques
    • En cas d'enthésite située au niveau des doigts, on parle de dactylite ou de doigts en saucisse
  • Association avec HLA-B27 positif et facteur rhumatoïde (FR) négatif (d'où la terminologie de spondylarthopathies séronégatives)


Radiography of the sacroiliac joints is essential in patients with suspected spondyloarthritis; radiographic evidence of sacroiliitis includes pseudo-widening of the joints, erosions, sclerosis, and ankylosis.

Spondylite ankylosante

  • Synonyme: maladie de Bechterew
  • Caractéristiques: Ankylosing spondylitis is a chronic inflammatory disease affecting the axial skeleton (including sacroiliac joints), entheses, and peripheral joints; HLA-B27 is present in up to 95% of patients.
  • Diagnostic:
    • presence of inflammatory back pain for 3 or more months in a person younger than age 45 years
    • limited lumbar spine motion
    • elevated inflammatory markers
    • evidence of bilateral sacroiliitis on imaging.
  • Traitement:
    • Physiothérapie +++
    • Several studies suggest that, in contrast to most forms of arthritis, continuous use of NSAIDs may help slow disease progression in ankylosing spondylitis
    • Si persistance: inhibiteurs du TNFα

Arthrite psoriasique

Psoriatic arthritis is an inflammatory joint disease associated with psoriasis, multiple possible joint patterns, enthesitis, tenosynovitis, and dactylitis.

  • Traitement: In recalcitrant psoriatic arthritis, the combination of methotrexate and a tumor necrosis factor α inhibitor (Infliximab) has shown efficacy in managing joint symptoms and slowing the progression of radiographic damage, including joint space narrowing and erosions.

Arthropathies associées aux maladies inflammatoires intestinales

Inflammatory bowel disease–associated arthritis occurs in three patterns: sacroiliitis/spondylitis, acute polyarticular peripheral arthritis, and chronic polyarticular peripheral arthritis; only the acute polyarticular form is related to flares of bowel disease.

  • Traitement: Long-term treatment options for bowel and joint symptoms associated with inflammatory bowel disease include sulfasalazine, azathioprine, 6-mercaptopurine, methotrexate, and the tumor necrosis factor α inhibitors adalimumab, certolizumab pegol, golimumab, and infliximab.

Arthrite réactionnelle

  • Can't see, can't pee, can't climb a tree

Reactive arthritis can occur 2 to 3 weeks following specific gastrointestinal and genitourinary infections; an asymmetric monoarticular or oligoarticular arthritis, dactylitis, and enthesitis can occur.

Spondylarthrite juvénile


  • MKSAP 2018