What are the extraarticular extraskeletal manifestations of Axial Spondyloarthritis?
Remembering the first few letters of the disease’s name (“Ank Spond”) will help in recalling these manifestations.
Aortic insufficiency (2%–6%), ascending aortitis, and other cardiac manifestations, such as conduction abnormalities (3%–5%), diastolic dysfunction, pericarditis, and ischemic heart disease (30%).
Neurologic: atlantoaxial (C1-2) subluxation (2%), cauda equina syndrome from spinal arachnoiditis, traumatic spinal fractures with myelopathy (C5-6, C6-7 most commonly), ossification of the posterior longitudinal ligament with spinal stenosis.
Kidney: secondary amyloidosis, IgA nephropathy (5%), chronic prostatitis.
Skin: psoriasis (10%) and to a lesser extent, erythema nodosum, keratoderma blennorrhagicum, pyoderma gangrenosum.
Pulmonary: upper lobe fibrosis, restrictive changes.
Ocular: acute anterior uveitis (20%–30% of patients).
Nephropathy (IgA, 5%).
Discitis or spondylodiscitis (Andersson lesions).
In addition, 30% to 60% of patients have asymptomatic microscopic colitis or Crohn’s-like lesions in their terminal ileum and colon, though overt inflammatory bowel disease presents in only 7% of axSpA patients. Patients with peripheral arthritis are more likely to have colitis lesions.
