The spondylarthropathies (SpA) are a family of rheumatic diseases classified together because of common features, including the absence of rheumatoid factor, the presence of mono- or oligoarthritis predominantly of the lower limbs, and inflammatory back pain (spondylitis, sacroiliitis). They are strongly associated with the class I HLA-antigen B27. Organ-specific manifestations such as acute anterior uveitis, inflammatory bowel disease, psoriasis, enthesitis (inflammation of the tendon-bone junction), carditis, conjunctivitis, and genital inflammation are characteristic features for this group of diseases. Patients may have more than one symptom at the same time or at different moments during life. A positive family history is an important hallmark of SpA, and reflects its genetic background.