What Is Undifferentiated Spondyloarthropathy?
The term undifferentiated spondyloarthritis (USpA) is used to describe spondylitis symptoms and signs in people who do not meet the criteria for an accurate diagnosis of ankylosing spondylitis or a related condition. If certain spondylitis symptoms are present but are not distinctive enough to warrant a specific diagnosis, a doctor may sometimes make an initial diagnosis of spondyloarthritis or unclassified spondyloarthritis.
Ankylosing spondylitis, reactive arthritis, juvenile spondyloarthritis, psoriatic arthritis, and enteropathic arthritis are all possible diagnoses for this individual's combination of symptoms. Some people with USpA will develop ankylosing spondylitis, a more distinct type of spondylitis, over time. Over the years, a lot of people with USpA have been told that they are just anxious and depressed or that they have fibromyalgia (a chronic disorder that causes a lot of pain in the muscles and soft tissues).
What Are the Symptoms of Undifferentiated Spondyloarthropathy?
Pain may be the only symptom experienced by individuals with undifferentiated spondyloarthropathies at times. In addition, individuals with undifferentiated spondyloarthropathies experience the following symptoms:
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Low back pain that lasts for a long time and starts slowly, usually radiating from the buttocks, before the age of 45 years.
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General body stiffness that gets worse upon waking and improves with exercise.
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A history of heel pain and swelling in the feet and hands.
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A general absence of abdominal symptoms, despite the fact that up to a third of patients experience intermittent diarrhea or more than two bowel movements per day.
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Intestinal inflammation can only be seen through an ileocolonscopy. The symptoms may resemble a bacterial infection or inflammatory bowel disease. There appears to be a strong connection between joint inflammation and intestinal inflammation with ongoing monitoring.
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Pain in both large and small joints, mostly in the legs and feet, However, this joint pain might be more severe on one side of the body than on the other.
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Inflammation of the eye.
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A red bumpy rash often goes along with a fever and intermittent joint pains.
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Symptoms that affect the genitals and urinary tract.
What Are the Causes and Risk Factors of Undifferentiated Spondyloarthropathy?
Similar to reactive arthritis, many people with undifferentiated spondyloarthropathies have the genetic marker HLA-B27, indicating that this disease is inherited. In addition, a pattern of mild intestinal inflammation or Crohn's disease has been observed in family studies.
According to some findings, other rheumatic symptoms, such as joint pain, may be brought on by intestinal inflammation in this condition. However, it could also be caused by a germ, virus, or bacteria.
How Is Undifferentiated Spondyloarthropathy Diagnosed?
Undifferentiated spondyloarthropathies are easy to mistake for other conditions due to the nature of their symptoms. It is less prevalent than other forms of rheumatoid arthritis. For an accurate diagnosis and appropriate treatment, it is essential to have a trained doctor who is knowledgeable about rheumatic conditions. Many doctors are unaware of how prevalent this issue is, particularly among women. Because it is frequently overlooked, doing homework by oneself is even more important. A doctor will look at the patient's body for a physical examination and review the symptoms. Then, they will run tests to rule out digestive problems.
To confirm a diagnosis of undifferentiated spondyloarthropathies, a doctor may order the following tests:
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An ileocolonoscopy to detect the presence of any inflammation in the intestines.
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Blood tests for a number of factors, including antibodies or immune system responses.
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An examination for the HLA-B27 gene. Ankylosing spondylitis can be ruled out with this test. That gene is present in more than 95 percent of people with ankylosing spondylitis but only a small percentage of people with undifferentiated spondyloarthropathy. An individual with the gene does not necessarily develop ankylosing spondylitis.
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The hands, feet, and hip joints may become eroded in patients. Rheumatoid arthritis-related joint damage may look something like these.
How Is Undifferentiated Spondyloarthropathy Treated?
Undifferentiated spondyloarthropathy does not currently have a cure, but patients can live full and productive lives with proper treatment. Medication, physical therapy, and exercise are typically the most common primary treatments for USpA. Applying heat or ice can also help alleviate joint pain for some patients.
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Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):
The majority of USpA patients will begin treatment by taking prescription non-steroidal anti-inflammatory (NSAID) medications like Diclofenac or Ibuprofen. Pain and inflammation can be temporarily reduced with NSAIDs.
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Biologics:
When nonsteroidal anti-inflammatory drugs (NSAIDs) alone do not alleviate symptoms, healthcare professionals may prescribe biologics. These can be self-injected or given by infusion into a vein in the office of a doctor. Although biologics are approved for the treatment of specific spondyloarthropathies like ankylosing spondylitis, inflammatory bowel disease-associated arthritis, and psoriatic arthritis, the FDA has not approved any biologics for the treatment of undifferentiated spondyloarthropathy. However, it is believed that patients with this disorder may benefit from biologics; their use is considered "off-label" because they have not been approved by the food and drug administration (FDA) for undifferentiated spondyloarthropathy.
Biologics are divided into two categories:
1. Most of the time, biologics, like tumor necrosis factor inhibitors (TNFi), are the first group of drugs that doctors recommend to patients. This is because they reduce inflammation in the body by binding to and neutralizing TNF.
2. Interleukin 17 inhibitors, a newer class of drugs, make up the second group of biologics.
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Corticosteroids:
Joint pain and inflammation can be reduced with the help of corticosteroids. These can be taken orally or locally by injecting them directly into the joint or joints where the patient is experiencing pain. Most of the time, corticosteroids are taken for short periods of time.
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Exercise:
For the treatment of undifferentiated spondyloarthropathy, exercise is very important. Stiffness and pain are alleviated by regular movement. Light exercise, like going for a walk, can help a person who is in pain get better when it happens. If the pain is too great, stretching while sitting or lying down is better. For USpA patients, there is no best exercise. All exercise is good, as long as it is low-impact (walking or swimming) and done often. A physical therapist can pair the patient with an appropriate exercise and stretching program or help them exercise on their own. Checking with a healthcare provider is advised before beginning an exercise program. Starting slowly and gradually building up stamina and strength. It is advised not to push oneself to the point of pain.
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Surgery:
Surgery may be beneficial for some patients who cannot be helped by medication or exercise. However, for USpA patients, this is typically the last option.
Conclusion
Most people can live a full life with undifferentiated spondyloarthropathy, despite the physical and emotional effects it can have on daily activities. The disease can be managed with the right combination of medication, medical care, and self-management through healthy lifestyle choices. For example, if the patient smokes, they are advised to make an effort to quit because smoking has negative effects and can make their condition worse. Any inquiries about the disease's potential treatments or management should be discussed with the healthcare provider.
