Seronegative arthritis

The seronegative spondyloarthropathies are a subgroup of the rheumatic diseases. As the name implies, patients with these diseases test negative for Rheumatoid factor. This group of diseases includes:

  • Ankylosing Spondylitis (AS)
  • Reactive arthritis
  • Enteropathic arthritis
  • Psoriatic arthritis

Clinical presentation

The seronegative arthritides may present as an inflammatory arthropathy or as back pain (particularly in patients with AS). When arthritis is associated with psoriasis or inflammatory bowel disease, it may either precede or follow diagnosis of the associated disease.
Ankylosing spondylitis frequently presents with back pain and stiffness. ŠiStockphoto/motoed
Ankylosing spondylitis frequently presents with back pain and stiffness. ŠiStockphoto/motoed

Read Chapter 79 in Cecil's Essentials of Medicine (6th edition) for more information about this group of diseases.

Review brief descriptions of the major types of seronegative arthritis by clicking on the titles below (on the left).

Ankylosing spondylitis
Reactive arthritis
Enteropathogenic arthritis
Psoriatic arthritis
Ankylosing spondylitis

AS predominantly affects males younger than 40 years. The HLA B27 marker is more common in patients with AS than in the general population. Insidious, chronic lumbar back pain that worsens with rest and improves with activity is characteristic. Patients often complain of pain in their buttocks and upper thighs and may experience soft tissue pain at the bone-tendon junctions. Over time, progressive restriction of spinal motion occurs with prominent kyphosis. Only 10% of patients develop peripheral arthritis however up to 20% may experience iritis which can lead to serious visual complications if untreated.
Young man with ankylosing spondylitis. (courtesy Dr. I. Dwosh)
Young man with ankylosing spondylitis. (courtesy Dr. I. Dwosh)


Review concepts related to the seronegative spondyloarthropathies by completing this crossword.