Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Watford Road, Harrow, Middlesex HA1 3UJ, London, UK; Department of Rheumatology, University College London Hospitals NHS Foundation Trust, 3rd Floor, 250 Euston Road, NW1 2PG, London, UK.
Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Watford Road, Harrow, Middlesex HA1 3UJ, London, UK; Department of Neuromuscular Diseases, University College London, 1st Floor, Russell Square House, 10-12 Russell Square, WC1B 5EH, London, UK; Centre for Rheumatology, University College London, Room 415, 4th Floor, Rayne Institute, 5 University St, Bloomsbury, London WC1E 6JF.
Rheum Dis Clin North Am. 2020 May;46(2):259-274. doi: 10.1016/j.rdc.2020.01.008.
Spondyloarthritis (SpA) is a chronic inflammatory condition that can have a predominately peripheral or axial presentation. Axial SpA (axSpA) affects the axial skeleton with either radiographic (r-axSpA) or nonradiographic (nr-axSpA) changes. Radiographic changes are a late disease feature and earlier disease stages can be identified by incorporating other imaging methods. The diagnosis of axSpA is a clinical diagnosis and classification criteria are not aimed to be diagnostic tools. The split between r-axSpA and nr-axSpA is artificial and we should move toward the unifying concept of axSpA. Our understanding of genetics, biomarkers, and immunopathophenotypes will drive further refinement of classification criteria.
脊柱关节炎（SpA）是一种慢性炎症性疾病，主要表现为外周或中轴。中轴型脊柱关节炎（axSpA）影响中轴骨骼，表现为放射学（r-axSpA）或非放射学（nr-axSpA）改变。放射学改变是疾病的晚期特征，通过结合其他影像学方法可以识别早期疾病阶段。axSpA 的诊断是临床诊断，分类标准并非旨在作为诊断工具。r-axSpA 和 nr-axSpA 的划分是人为的，我们应该朝着 axSpA 的统一概念发展。我们对遗传学、生物标志物和免疫病理表型的理解将推动分类标准的进一步细化。
