Case Report
2019 March
Volume : 7 Issue : 1

A case of rheumatoid spondyloarthritis!

Sujatha Narayanan, Balameena S

Pdf Page Numbers :- 7-10

Sujatha Narayanan1,* and Balameena S1


1Department of Rheumatology, Institute of Rheumatology, MMC & RGGGH, Chennai


*Corresponding author: Dr. Sujatha Narayanan, Department of Rheumatology, Institute of Rheumatology, Madras Medical College (MMC) & Rajiv Gandhi Government General Hospital (RGGGH), Chennai, India. Mobile: +91 9791032841; Email:


Received 03 October 2018; Revised 30 November 2018; Accepted 07 December 2018; Published 15 December 2018


Citation: Sujatha N, Balameena S. A case of rheumatoid spondyloarthritis! J Med Sci Res. 2019; 7(1):7-10. DOI:


Copyright: © 2019 Sujatha N et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Coexistence of rheumatoid arthritis and spondyloarthritis in one patient is rare. Here we report a 42-year-old male with symmetrical small and large joint arthritis of upper and lower limbs, bilateral sacroilitis without clinical evidence of psoriasis or inflammatory bowel disease. He had high titres of both rheumatoid factor (RF) (125.5IU/ml) and anti-citrullinated peptide antibodies (ACPA) (>200U/mL) with human leukocyte antigen (HLA) typing revealing positivity for both HLA B27 and HLA DR4. Patient was managed with steroids, analgesics, Disease-modifying anti-rheumatic drugs (DMARDs) and biologicals. Our patient’s initial clinical presentation and serology were suggestive of Rheumatoid arthritis but later he developed features of spondyloarthritis. Though he had genetic predisposition to both the diseases, clinical features and imaging studies on follow up were more in favour of spondyloarthritis. It is unclear as to whether the small joint arthritis of hands could be attributed to rheumatoid arthritis or spondyloarthritis. It is possible that these two conditions probably occur by chance or this could constitute an overlap syndrome between the two rheumatic conditions. Such cases pose difficulties in diagnosis and further study of such patients may help in early diagnosis and effective intervention.


Keywords: rheumatoid arthritis; spondyloarthritis; psoriatic arthritis