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Evaluating Inflammatory Versus Mechanical Back Pain in Individuals with Psoriatic Arthritis: A Review of the Literature
Psoriatic arthritis (PsA) is a chronic immune-mediated disease characterized by psoriatic skin and nail changes, peripheral joint inflammation, enthesitis, dactylitis, and/or axial involvement, either alone or in combination with each other. The presence of axial involvement has been shown to be a m...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Healthcare
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695767/ https://www.ncbi.nlm.nih.gov/pubmed/32935330 http://dx.doi.org/10.1007/s40744-020-00234-3 |
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author | Grinnell-Merrick, Linda L. Lydon, Eileen J. Mixon, Amanda M. Saalfeld, William |
author_facet | Grinnell-Merrick, Linda L. Lydon, Eileen J. Mixon, Amanda M. Saalfeld, William |
author_sort | Grinnell-Merrick, Linda L. |
collection | PubMed |
description | Psoriatic arthritis (PsA) is a chronic immune-mediated disease characterized by psoriatic skin and nail changes, peripheral joint inflammation, enthesitis, dactylitis, and/or axial involvement, either alone or in combination with each other. The presence of axial involvement has been shown to be a marker of PsA severity; however, there is no widely accepted definition of axial involvement in PsA (axPsA) or consensus on how or when to screen and treat patients with suspected axPsA. Chronic back pain is a prominent feature of axPsA and is thought to have a relevant role in early identification of disease. Chronic back pain can be caused by inflammatory back pain (IBP) or mechanical back pain (MBP). However, MBP can complicate recognition of IBP and delay diagnosis of axPsA. While MBP can also be associated with chronic back pain of ≥ 3 months in duration that is typical of IBP, IBP is characterized by inflammation of the sacroiliac joint and lower spine that is differentiated from MBP by key characteristic features, including insidious onset at age < 40 years, improvement with exercise but not with rest, and nighttime pain. This review discusses the differences in identification and management of IBP and MBP in patients with PsA with axPsA. The summary of available evidence highlights the importance of appropriate and timely screening, difficulties and limitations of differential diagnoses and treatment, and unmet needs in axPsA. |
format | Online Article Text |
id | pubmed-7695767 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-76957672020-11-30 Evaluating Inflammatory Versus Mechanical Back Pain in Individuals with Psoriatic Arthritis: A Review of the Literature Grinnell-Merrick, Linda L. Lydon, Eileen J. Mixon, Amanda M. Saalfeld, William Rheumatol Ther Review Psoriatic arthritis (PsA) is a chronic immune-mediated disease characterized by psoriatic skin and nail changes, peripheral joint inflammation, enthesitis, dactylitis, and/or axial involvement, either alone or in combination with each other. The presence of axial involvement has been shown to be a marker of PsA severity; however, there is no widely accepted definition of axial involvement in PsA (axPsA) or consensus on how or when to screen and treat patients with suspected axPsA. Chronic back pain is a prominent feature of axPsA and is thought to have a relevant role in early identification of disease. Chronic back pain can be caused by inflammatory back pain (IBP) or mechanical back pain (MBP). However, MBP can complicate recognition of IBP and delay diagnosis of axPsA. While MBP can also be associated with chronic back pain of ≥ 3 months in duration that is typical of IBP, IBP is characterized by inflammation of the sacroiliac joint and lower spine that is differentiated from MBP by key characteristic features, including insidious onset at age < 40 years, improvement with exercise but not with rest, and nighttime pain. This review discusses the differences in identification and management of IBP and MBP in patients with PsA with axPsA. The summary of available evidence highlights the importance of appropriate and timely screening, difficulties and limitations of differential diagnoses and treatment, and unmet needs in axPsA. Springer Healthcare 2020-09-15 /pmc/articles/PMC7695767/ /pubmed/32935330 http://dx.doi.org/10.1007/s40744-020-00234-3 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Review Grinnell-Merrick, Linda L. Lydon, Eileen J. Mixon, Amanda M. Saalfeld, William Evaluating Inflammatory Versus Mechanical Back Pain in Individuals with Psoriatic Arthritis: A Review of the Literature |
title | Evaluating Inflammatory Versus Mechanical Back Pain in Individuals with Psoriatic Arthritis: A Review of the Literature |
title_full | Evaluating Inflammatory Versus Mechanical Back Pain in Individuals with Psoriatic Arthritis: A Review of the Literature |
title_fullStr | Evaluating Inflammatory Versus Mechanical Back Pain in Individuals with Psoriatic Arthritis: A Review of the Literature |
title_full_unstemmed | Evaluating Inflammatory Versus Mechanical Back Pain in Individuals with Psoriatic Arthritis: A Review of the Literature |
title_short | Evaluating Inflammatory Versus Mechanical Back Pain in Individuals with Psoriatic Arthritis: A Review of the Literature |
title_sort | evaluating inflammatory versus mechanical back pain in individuals with psoriatic arthritis: a review of the literature |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695767/ https://www.ncbi.nlm.nih.gov/pubmed/32935330 http://dx.doi.org/10.1007/s40744-020-00234-3 |
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