血清阴性脊柱关节病
（ Serum RF negative spondylarthropathy）
Department of Internal Medicine
Shanghai Medical College
Dr,Hejian ZOU
http://www.hjzou.com
【 Clinical features】
RF negtive
low back pain and stiffness
other joints
enthesitis
familial aggregation
HLA-B27 related
【 Classification】
? Ankylosing spondylitis
? Reiter’s syndrome
? Arthropathy of inflammatory bowel diseases
? Psoriatic arthritis
? Reactive arthritis
? Undifferentiated spondyloarthropathies
【 Criteria 】
1,Low back pain at least 3 months’ duration improved by exercise
and not relieved by rest
2,Limitation of lumbar spine in sagittal and front planes
3,Chest expansion decreased relative to normal value for age
and sex
4,Bilateral sacroiliitis grade 2-4
5,Unilateral sacroiliitis grade 3-4
Definite ankylosing spondylitis if unilateral grade 3 or 4,or
bilateral grade 2-4 sacroiliitis and any clinial criterion
【 Clinical manifestations】
1,Age,<40
2,Onset,insidiously
3,Pathology,enthesis
4,Clinical manifestation,
low back pain and stiffness
arthritis
eye disease
cardiovascular disease
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【 management】
1,Physiotherapy
2,NSAIDs
3,DMARDs
4,Surgery SASP,
MTX
Thank You!