Поражение позвоночника при псориатическом артрите

Среди всех клинических проявлений псориатического артрита (ПсА), к которым относятся периферический артрит, дактилит, энтезит и спондилит, наименее изучено поражение позвоночника, а общепринятая его дефиниция, единая терминология и диагностические критерии в настоящее время отсутствуют. В ревматологическом сообществе также нет консенсуса в отношении методов визуализации, необходимых для диагностики поражения осевого скелета при ПсА, а методы оценки активности и терапевтическая тактика заимствованы из существующих рекомендаций для анкилозирующего спондилита (АС) и аксиального спондилоартрита (аксСпА). Однако несмотря на определенное сходство в иммунопатогенетических механизмах аксиального ПсА (аксПсА) и аксСпА, существуют и различия, которые могут определять разный ответ на терапию у этих пациентов. В настоящем обзоре представлен анализ результатов изучения патологии позвоночника при ПсА. В статье будут обсуждены генетические особенности, клинические проявления, методы визуализации, дифференциальная диагностика и терапия аксПсА.

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