小结
定义
中轴型脊柱关节炎（axial spondyloarthritis, AxSpa）是一种慢性进行性炎性关节病。患者可表现为严重疼痛和脊椎僵硬，最终可导致脊柱和骶髂关节放射影像学改变。此放射影像学改变阶段被称为强直性脊柱炎（ankylosing spondylitis, AS）。此疾病进展可能导致脊柱融合。脊柱完全融合的患者会出现严重残疾。
AS 多累及中轴骨，但也常累及外周关节、附着点（肌腱或韧带附着于骨骼的部位），以及关节以外的部位（如眼部和肠道）。[1][2]
放射学阴性中轴型脊柱关节炎（non-radiographic axial spondyloarthritis, nr-axSpA）指的是在磁共振成像（magnetic resonance imaging, MRI）上可见的中轴型炎症，而此炎症并未对骶髂关节造成实质性侵蚀损伤。若骶髂关节呈 MRI 阳性，可将患者分类至 nr-axSpA。
[Figure caption and citation for the preceding image starts]: 竹节样脊柱Student BMJ 2002;10:303-352.© BMJ 出版集团有限公司 2008 [Citation ends].
病史和体格检查
诊断性检查
治疗流程
撰稿人
作者
Antoni Chan, MBChB, FRCP, PhD
Consultant
Rheumatology Department
Royal Berkshire NHS Foundation Trust
Reading
UK
利益声明
AC has served on the advisory boards for MSD, Novartis, and Sanofi; contributed to educational events for Janssen, MSD, Novartis, Sanofi, and Celgene; been on the speaker bureau for Janssen, Pfizer, and Novartis; and received travel grants from AbbVie, UCB, Lilly, and Pfizer to attend educational conferences.
Sarah Sacks, MBBS, BSc
Specialist Registrar in Rheumatology
Stoke Mandeville Hospital
Aylesbury
UK
利益声明
SS declares that she has no competing interests.
鸣谢
Dr Antoni Chan and Dr Sarah Sacks would like to gratefully acknowledge Dr Jessica Gunn, Dr Sarah Keidel, Dr Millicent Stone, Dr Raj Sengupta, Dr Athimalaipet V. Ramanan, and Dr Emma Pomeroy, the previous contributors to this topic.
利益声明
JG, SK, RS, and AVR declare that they have no competing interests. MS is an author of several references cited in this topic. EP is an author of a reference cited in this topic.
同行评议者
Roger Sturrock, MD, FRCP
Professor of Rheumatology
Centre for Rheumatic Diseases
University Department of Medicine
Glasgow Royal Infirmary University Trust
Glasgow
UK
利益声明
RS is an author of a reference cited in this topic.
Andrew Keat, MBBS
Consultant Physician and Rheumatologist
Northwick Park Hospital
Harrow
UK
利益声明
AK declares that he has no competing interests.
Karl Gaffney, BCh, BAO (Hons), FRCPI, FRCP
Consultant
Norfolk and Norwich University Hospital
Norwich and the Cromer & District Hospital
Cromer
UK
利益声明
KG is an author of a reference cited in this topic.
Alexios G. Carayannopoulos, DO, MPH
Interventional Spine Physiatrist
Pain Medicine Specialist
Medical Director
Spine Center
Lahey Clinic
Burlington
MA
利益声明
AGC declares that he has no competing interests.
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