Seronegative Spondyloarthropathy

Seronegative Spondyloarthropathy (SpA) is a group of diseases that affect the joints. Ankylosing Spondylitis, Psoriatic Arthritis, Reactive Arthritis, Juvenile Arthritis, and Inflammatory Bowel Disease all belong to this class of inflammatory arthritis.

This is an autoimmune disease. The immune system of an infected person attacks their cells. SpA affects the spine but can also attacks other body areas. Hips, knees, ankles, and neck are affected. Inflammation in the body leads to pain in the affected areas.

Symptoms of Seronegative Spondyloarthropathy

Common symptoms are back pain, morning stiffness, sleep disturbances, joint pain, joint swelling, and eye infections. SpA affects the entheses of the joints. This is where the ligaments and tendons insert into the bone of joints. My hips, knees, neck, sacrum and shoulder are affected. My pain is at its worst at bedtime. All day I just keep putting one foot in front of the other. By the evening my pain is at a high level. It takes me a long time to fall asleep and I am up several times during the night. This lead to chronic fatigue. I never feel well-rested. It takes me about 20-25 minutes to get rid of the stiffness in my joints each morning.

The Long Road to a Seronegative Spondyloarthropathy Diagnosis

It takes 7-10 years for a person to get a diagnosis of SpA. In the beginning, my diagnosis was reactive arthritis. My disease started after returning home from a vacation in the Dominican Republic. On the last day of our vacation, I had an intestinal infection. Two weeks later I woke up with sore and swollen hands. Then a few months later my foot swelled up overnight and walking was difficult. I was added to a waitlist to be seen by a rheumatologist. It took 18 months to get in and see her. The day I saw her she saw two swollen joints. She said that given my family history she would follow me as I was at higher risk of developing spondyloarthropathy. My doctor put me under the Psoriatic (perphrial) catagory even though I have some AS symptoms also.

My Genetic History

At ten years old my brother had Juvenile Arthritis. He spent time at Sick Kids, had surgery and had to wear a knee brace. At 20, my sister had Chron’s disease. Given I had two first degree relatives with spondyloarthropathy I was at increased risk to develop it. Three years later I am given the official diagnosis and put on Methotrexate.

Medications

A year passed and I wasn’t feeling any better. I had more swollen joints and she added a biological medication. Cimzia was the new addition. During this time, I was suffering from my right hip. An MRI saw a cyst and labral tears. A decision to do the arthroscopic labral repair occurred. The surgeon saw lots of inflammation in the hip. The labral repair did not improve the pain in my hip. The cyst came back and the labral tore again. I had a second labral repair that was also unsuccessful. This led to me having a total hip replacement in 2021. The hip surgeon seen end stage arthritis. After the hip replacement, my rheumatologist started me on a third medication. This time she added Sulfasalazine.

There is so much that I can cover under this umbrella. I hope to write some posts about the medications that I have trialed both successfully and unsuccessful.