Final Flashcards
This is a chonic, inflammatory arthritis primarily affecting the articulations & ligs of the spine & pelvis
Ankylosing Spondylitis
Ankylosing Spondylitis is AKA?
Marie-Strumpell, Bechterev, rhizomelic spondylitis
Ankylosing Spondylitis is a common cause of low back pain in what group of people?
Young males (15-35 yrs of age; 9:1 M-to-F)
Where is aching/stiffness M/C w/ Ankylosing Spondylitis?
In sacral region
What is the typical clinical presentation of Ankylosing Spondylitis?
Pain at max in morning Pain/tenderness over bony prominences Chest pain (costochondral involvement) Fatigue,low grade fever Iritis, heart problems, upper lung fibrosis
What % of pt’s w/ Ankylosing Spondylitis have peripheral involvement?
up to 50%
What are typical lab findings w/ Ankylosing Spondylitis?
Positive HLA-B27 (90-95% of cases)
ESR
Negative for RF
What are the characteristic sites of involvement for Ankylosing Spondylitis?
SI joints (M/C; hallmark) Apophyseal joints Costovertebral joints Pubic symphysis Discovertebral Manubriosternal joints
What are basic features of Ankylosing Spondylitis radiographically in the SI joints?
Reactive Sclerosis Osteoporosis Bony ankylosis Erosions Typically bilateral & symmetrical
What are the most diagnostic views for Ankylosing Spondylitis in the SI joints?
PA angulated spots or SI views
What are the stage 1 changes in SI joints w/ Ankylosing Spondylitis?
Pseudo-widening of joint
What are the stage 2 changes in SI joints w/ Ankylosing Spondylitis?
Erosive & sclerotic changes
What are the stage 3 changes in SI joints w/ Ankylosing Spondylitis?
Ankylosis 50% (7-23 years)
What radiographic signs are assoc. w/ ankylosing spondylitis in the SI?
Ghost joint margins
Star sign
Erosive changes w/ ankylosing spondylitis in the SI are seen more on what part of the joint?
Iliac side of the joint & lower 1/3rd of the joint
Where are the earliest spinal manifestations radiographically of ankylosing spondylitis?
Thoracolumbar region (M/C)
This is an erosion at the corner of a vert. body assoc. w/ ankylosing spondylitis
Romanus lesion
Vert. bodies become what shape w/ ankylosing spondylitis?
Squared contour, barrel shaped
This radiographic sign is d/t osteitis in the spine of a pt w/ ankylosing spondylitis
Shiny corner sign
Ossification of the outer edges of the disc in a pt w/ ankylosing spondylitis is called what?
Marginal syndesmophytes
Names assoc. w/ ankylosing spondylitis in the spine?
Bamboo spine, Trolley-track, dagger sign
Type of fx assoc. w/ ankylosing spondylitis in the spine?
Carrot-stick fx
Lesion that is assoc. w/ ankylosing spondylitis that looks like an infection & is M/C in the C-spine
Anderson lesion
This arthropathy is assoc. w/ ulcerative colits & crohn’s disease
Enteropathic arthropathy
Enteropathic Arthropathy affects what group of people?
Young adults
What is a typical clinical symptom of enteropathic arthropathy?
Peripheral arthralgias w/ rapid resolution (knee, ankle, elbow, wrist)
What % of time is there spinal involvement w/ enteropathic arthropathy?
5%
What lab test is positive w/ enteropathic arthropathy?
HLA-B27
How does enteropathic arthropathy appear radiographically?
Similar to ankylosing spondylitis (bilateral & symmetrical)
Common skin disorder assoc. w/ joint disease characterized by peripheral joint destruction & deformity, sacroiliitis, & non-marginal syndesmophytes
Psoriatic Arthritis
What is the pathophysiology of Psoriatic Arthritis?
Similar to RA
Pannus affects cartilage less &erosions are smaller & slower in development
Periostitis
What are the M/C joints affected by Psoriatic Arthritis?
DIP of hand & foot
What age group is M/C affected by Psoriatic Arthritis?
20-50 yrs of age
What are clinical features of Psoriatic Arthritis?
Skin lesions characteristic of psoriasis
Nail changes (incidence of arthritis increased)
Acute & chronic joint pain especially in DIP joints
Morning stiffness
Sausage digit
What are laboratory features seen w/ Psoriatic Arthritis?
Positive HLA-B27 (30%)
Hyperuricemia
Increased ESR