Zusammenfassung
Die axiale Spondyloarthritis (SpA) ist die wichtigste Unterform der SpA. Falls röntgenologisch eine eindeutige Sakroiliitis nachweisbar ist, kann die Diagnose einer ankylosierenden Spondylitis (Morbus Bechterew) gestellt werden. Es gibt aber immer noch eine Verzögerung von im Mittel 5–10 Jahren vom Auftreten der ersten Symptome bis zur Diagnostellung. Ein wichtiger Grund hierfür liegt darin, dass röntgenologische Veränderungen meist erst einige Jahre nach Beginn der Erkrankung auftreten, trotz des Vorhandenseins von Entzündung in Sakroiliakalgelenken und Wirbelsäule, die sich im MRT nachweisen lässt und die sich in Form von Schmerzen und Steifigkeit manifestiert. Eine Frühdiagnose dieser Erkrankung wird aber zunehmend wichtig, da effektive Therapien zur Verfügung stehen, die vermutlich wirksamer sind, je früher sie eingesetzt werden. Neue Strategien zur Frühdiagnose und zur frühen Identifizierung dieser Patienten in der Allgemeinarztpraxis werden diskutiert.
Summary
The axial spondyloarthritis (SpA) is the most important disease out of the whole group of SpA. If a sacroiliits is clearly detectable by x-rays a diagnosis of ankylosing spondylitis can be made. However, there is still a delay of 5–10 years from the first symptoms until a final diagnosis is made. An important reason for this is the fact that radiological changes are often only detectable after several years of disease, despite the presence of inflammation as detected by MRI and the presence of clinical manifestations such as pain and stiffness. An early diagnosis becomes more and more important because effective therapies have become available which are probably even more effective if given early. New strategies how to make an early diagnosis and how primary care physicians can screen for these patients are discussed.
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Rudwaleit, M., Sieper, J. Frühdiagnose von Spondyloarthritiden mit besonderer Betonung auf die axialen Formen. Z. Rheumatol. 64, 524–530 (2005). https://doi.org/10.1007/s00393-005-0791-8
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DOI: https://doi.org/10.1007/s00393-005-0791-8