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Erschienen in: CME 11/2017

24.11.2017 | Spondyloarthritiden | CME Fortbildung

Axiale und periphere Spondyloarthritiden

Ursachen, Diagnose & Therapie

verfasst von: Prof. Dr. med. Martin Rudwaleit

Erschienen in: CME | Ausgabe 11/2017

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Zusammenfassung

Die Spondyloarthritiden (SpA) sind entzündlich rheumatische Erkrankungen mit Manifestationen am Achsenskelett, peripheren Gelenken und Sehnen sowie extra-skelettal. In der jüngeren Nomenklatur wird die vorwiegend axiale SpA von der peripheren SpA unterschieden. Die axiale SpA wird wiederum unterteilt in die röntgenologische axiale SpA — synonym mit anklyosierender Spondylitis — und der nicht-röntgenologischen axialen SpA, definiert als axiale SpA ohne eindeutige Sakroiliitis im Röntgenbild. Genetische Faktoren spielen eine wichtige Rolle, den stärksten Einfluss hat HLA-B27. Der IL23/17 Signalweg ist immunologisch bedeutsam und liefert neue therapeutische Targets. Leitsymptom der axialen SpA ist der entzündliche Rückenschmerz mit seinen bestimmten Charakteristika. Diagnostisch sind ferner HLA-B27 sowie der Nachweis einer Sakroiliitis in der Bildgebung (Röntgen oder MRT) wichtige Parameter. Therapeutisch kommen Bewegungstherapie, NSAR (Erstlinientherapie) und Biologika (Zweitlinientherapie bei axialer SpA) zur Anwendung. Konventionelle Basistherapien sind nur bei peripherer Arthritis effektiv.
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Metadaten
Titel
Axiale und periphere Spondyloarthritiden
Ursachen, Diagnose & Therapie
verfasst von
Prof. Dr. med. Martin Rudwaleit
Publikationsdatum
24.11.2017
Verlag
Springer Medizin
Erschienen in
CME / Ausgabe 11/2017
Print ISSN: 1614-371X
Elektronische ISSN: 1614-3744
DOI
https://doi.org/10.1007/s11298-017-5991-4

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