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Diagnose und Therapie der axialen Spondyloarthritis einschließlich des Morbus Bechterew

Diagnosis and therapy of axial spondyloarthritis including ankylosing spondylitis (Bechterew’s disease)

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Zusammenfassung

Der Begriff axiale Spondyloarthritis umfasst Patienten mit etablierten Röntgenveränderungen in den Sakroiliakalgelenken und/oder in der Wirbelsäule (klassischer Morbus Bechterew), aber auch Patienten mit nichtröntgenologischer axialer Spondyloarthritis, bei denen die Entzündung z. B. nur in der Magnetresonanztomographie(MRT)-Untersuchung nachweisbar ist. Diese Untersuchung spielt eine ganz wichtige Rolle für die Diagnose dieser Erkrankung, und eine Frühdiagnose wird in der Regel mit dem Nachweis einer Kombination verschiedener klinischer, Labor- und bildgebender Parameter gestellt. Von den medikamentösen Therapien sind nur nichtsteroidale Antirheumatika und Tumornekrosefaktor(TNF)-α-Blocker effektiv. Patienten mit kurzer Krankheitsdauer und erhöhten Entzündungsparametern sprechen am besten auf eine medikamentöse Therapie an und sollten daher auch am konsequentesten behandelt werden.

Abstract

The term axial spondyloarthritis covers patients with established structural changes visible on x-ray in sacroiliac joints and/or in the spine (classical ankylosing spondylitis) but also patients with non-radiographic axial spondyloarthritis in whom early inflammatory signs of the disease can only be visualized with magnetic resonance imaging (MRI). The MRI technique plays an important role in the diagnosis of this disease and an early diagnosis is normally based on a combination of clinical, laboratory and imaging parameters. Only non-steroidal anti-inflammatory drugs and TNF-α blockers are effective in the treatment of axial spondyloarthritis. Patients with short disease duration and elevated acute phase reactant levels demonstrate best therapy response and, therefore, should be closely followed-up and consistently treated.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: D. Poddubnyy mit Abbott, MSD, Pfizer; J. Sieper mit Abbott, MSD, Pfizer, UCB.

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  1. Rheumatologie, Medizinische Klinik I, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland

    D. Poddubnyy &  J. Sieper

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  1. D. Poddubnyy
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  2. J. Sieper
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Correspondence to J. Sieper.

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Poddubnyy, D., Sieper, J. Diagnose und Therapie der axialen Spondyloarthritis einschließlich des Morbus Bechterew. Orthopäde 41, 533–538 (2012). https://doi.org/10.1007/s00132-012-1926-7

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  • DOI: https://doi.org/10.1007/s00132-012-1926-7

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