Internist (Berl). 2017 Jul;58(7):687-701. doi: 10.1007/s00108-017-0263-7.
[Article in German]


Spondyloarthritides (SpA) are inflammatory rheumatic diseases affecting the axial skeleton, peripheral joints and entheses, and also manifest at extraskeletal sites. According to the more recently introduced nomenclature, predominant axial SpA is distinguished from predominant peripheral SpA. Axial SpA is further divided into radiographic and nonradiographic axial SpA. Genetic factors are relevant, with HLA-B27 being most important. The interleukin 23/17 pathway seems to be relevant and points towards new therapeutic targets. Inflammatory back pain is the leading symptom in axial SpA and has certain characteristics. In addition, HLA-B27 and sacroiliitis on imaging are important for diagnosis. Therapy consists of physiotherapy, nonsteroidal anti-inflammatory drugs (first line) and biologicals (second line). Conventional disease-modifying antirheumatic drugs are effective only in peripheral arthritis.

Keywords: Anti-inflammatory agents, non-steroidal; Arthritis, psoriatic; Sacroiliitis; Spondylitis, ankylosing; Tumor necrosis factor alpha, inhibitors.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antirheumatic Agents / therapeutic use
  • HLA-B27 Antigen / genetics
  • Humans
  • Sacroiliitis / diagnostic imaging
  • Spondylarthritis* / classification
  • Spondylarthritis* / diagnostic imaging
  • Spondylarthritis* / genetics
  • Spondylarthritis* / therapy
  • Spondylitis, Ankylosing / diagnostic imaging


  • Anti-Inflammatory Agents, Non-Steroidal
  • Antirheumatic Agents
  • HLA-B27 Antigen