Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK Systems > 8: Spiondyloarthropathy and Inflammatory Mimic Conditions > Flashcards

8: Spiondyloarthropathy and Inflammatory Mimic Conditions Flashcards

1
Q

list some seronegative arthritis syndromes (spondyloarthropathies)

A
  • axial spondyloarthritis (Ankylosing Spondylitis)
  • psoriatic arthritis
  • bowel related arthritis (Crohn’s, UC)
  • reactive arthritis
  • others
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is ankolysing spondylitis?

A

a seronegative inflammatory arthritis, primarily involving the axial skeleton, more commonly found in males between 20-30 years old.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ankylosing spondylitis clinical features (NY criteria)

A
  • inflammatory back pain
  • limitation of movements in antero-posterior as well as lateral planes at lumbar spine
  • limitation of chest expansion
  • bilateral sacroiliitis on x-rays
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what spinal mobility tests are performed when assessing a patient with potential ankylosing spondylitis?

A
  • modified Schober
  • lateral spine flexion
  • occiput to wall and tragus to wall
  • cervical rotation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what laboratory investigations can be performed for suspected ankylosing spondylitis?

A

No lab tests are diagnostic

Primary care:
- FBC
- inflammatory markers

Secondary care:
- HLA-B27 is not diagnostic, its sensitivity and specificity are around 90%, SHOULD NOT be tested in all patients with back pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what can a pelvic x-ray in a patient with ankylosing spondylitis show?

A
  • sacroiliitis
  • early cases: sclerosis or minimal erosion of SI joint
  • advanced disease: ankylosing or fusion of the joint
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what could a lumbar x-ray in a patient with ankylosing spondylitis show?

A
  • vertebral bodies may become squared.
  • in later stages, bony bridges called syndesmophytes form between adjacent vertebrae, and there is ossification of spinal ligaments
  • in late disease, there may be complete fusion of the vertebral column, known as bamboo spine.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ASAS classification criteria for diagnosing axial spondyloarthritis (SpA)

A
  • in patients with 3 or more month back pain and age at onset < 45 years
  • sacroiliitis on imaging + 1 or more SpA symptoms OR
  • HLA-B27 + 2 or more SpA symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are some other features of ankylosing spondylitis?

non MSK related except for two

A
  • enthesitis (achilles tendonitis, plantar fasciitis)
  • peripheral arthritis
  • anterior uveitis
  • aortitis > aortic regurgitation
  • pulmonary fibrosis
  • IgA nephropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

management of ankylosing spondylitis

A
  • physio
  • NSAIDs
  • steroids - short-term
  • conventional synthetic DMARDS e.g. methotrexate, sufasalazine, leflunomide
  • biologic DMARDs e.g. anti-TNF, anti-IL-17, JAK inhibitors
  • treatment/prevention of osteoporosis
  • surgery: joint replacements and spinal surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the treatment for psoriatic arthritis?

A
  • conventional synthetic DMARDS e.g. methotrexate, sufasalazine, leflunomide
  • cyclosporine
  • biologic DMARDs e.g. anti-TNF, anti-IL-17 and IL-23
  • steroids
  • physio and occupational therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is reactive arthritis?

A

Reactive arthritis is a sterile inflammatory arthritis that typically occurs within four weeks of an infection, often as a result of sexually transmitted or GI infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

reactive arthritis risk factors

A
  • male sex (M:F 1.5:1)
  • early adulthood 20-40y
  • HLA-B27 positive
  • preceding STI or GI infection, most commonly Chlamydia, Shigella, Yersinia or Salmonella
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what skin and mucous membrane conditions can be caused by reactive arthritis?

A
  • keratoderma blenorrhagica
  • circinate balanitis
  • urethritis
  • conjunctivitis
  • iritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Reiter’s syndrome is a triad of?

A

arthritis
urethritis
conjunctivitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are some prognostic signs for chronicity of reactive arthritis?

i.e. for reactive arthritis becoming chronic - having recurrent attacks

A
  • hip/heel pain
  • high ESR
  • family history and HLA-B27 +
17
Q

what is the treatment for acute reactive arthritis?

A
  • NSAID
  • joint injection (if infection excluded)
  • antibiotics in chlamydia infection (contacts as well)
18
Q

what is the treatment for chronic reactive arthritis?

A
  • NSAID
  • DMARD e.g. sulphasalazine, methotrexate
19
Q

how does enteropathic arthritis present?

A
  • can present with both peripheral and/or axial disease
  • enthesopathy commonly seen
20
Q

enteropathic arthritis is commonly associated with which conditions?

A
  • commonly associated with IBD e.g. UC or Crohn’s
  • rarely seen with infectious enteritis, Whipple’s disease and Coeliac disease.
21
Q

what is the treatment for enteropathic arthritis?

A
  • NSAIDs difficult to use
  • sulfasalazine
  • steroids
  • methotrexate
  • anti-TNF
  • bowel resection may alleviate peripheral disease

MSK Systems (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions