Brainscape's Knowledge GenomeTM

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


See full index

Year 2- MSK > Inflammatory Arthritis > Flashcards

Inflammatory Arthritis Flashcards

Soft tissue rheumatism, Spondyloarthropathy, Psoriatic Arthritis, Enteropathic Arthritis, Reactive arthritis.

1
Q

What is the definition of soft tissue rheumatism?

A

Inflammation/damage to ligaments, tendons, muscles or nerves near a joint rather than either the bone or cartilage

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

What is the most common area for pain for those who suffer with Soft tissue rheumatism

A

Shoulder

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

What conditions are associated with the elbow?
(To do with Soft tissue rheumatism)

A
  • Medial and lateral epicondylitis
  • Cubital tunnel syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the conditions associated with the wrist?
( To do with Soft tissue rheumatism )

A
  • De-Quervains tenosynovitis
  • Carpal tunnel syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What condition is associated with the foot?
(To do with Soft tissue rheumatism)

A

Plantar fascitis

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

What are the two main clinical presentations of Soft tissue rheumatism

A
  1. Pain confined to a specific site
  2. Localized soft tissue pain (fibromyalgia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Investigations for soft tissue rheumatism are what?

A

(1) Clinical history and examination⁠

⁠​
(2) X-ray - particularly useful for calcific tendonitis⁠

⁠​
(3) Ultrasound scans⁠

⁠​
(4) MRI if the condition fails to settle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment for soft tissue rheumatism

A

(1) Pain control⁠
(2) Rest and ice compressions⁠
(3) Physical Therapy (PT)⁠

If fails, then steroids or surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is spondyloarthropathy?

A

a family of inflammatory arthritides characterised by involvement of both the spine and joints, primarily affecting genetically predisposed individuals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does the mnemonic PAIR stand for in relation to diseases associated with HLA B27?

A

PAIR

Psoriatic arthritis
Ankylosing spondylitis
IBS
Reactive arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of MHC is HLA B27?

A

Class 1 MHC type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the difference between mechanical and inflammatory back pain?

A

Mechanical back pain worsens with activity and improves with rest

Inflammatory back pain improves with activity and worsens with rest

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

What are the non-pharmacological management strategies for spondyloarthropathies?

A

Exercise, especially swimming

Physiotherapy

Occupational Therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the first line pharmacological treatment for spondyloarthropathies?

A

NSAIDs like ibuprofen → not for IBS

Corticosteroids → for joint injections

Topical steroid eye drops → managing ocular inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the second treatment for spondyloarthropathies?

A

DMARDS

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

What is the third-line treatment for spondyloarthropathies?

A

Biologics such as Anti-TNF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is Psoriatic Arthritis?

A

An inflammatory arthritis associated with psoriasis, but 10-15% of patients can have PsA without skin psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are common extra-articular symptoms of Psoriatic Arthritis?

A

Nail involvement - pitting

Eye disease - Uveitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What blood test findings are common in Psoriatic Arthritis?

A

(1) ↑ inflammatory markers

(2) Negative RF and Anti-CCP to rule out RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the first-line pharmacological treatment for Psoriatic Arthritis?

A

NSAIDs are the first-line treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the next step if NSAIDs do not control Psoriatic Arthritis symptoms?

A

DMARDs (e.g., methotrexate, sulfasalazine)

+

Consider anti-TNF therapy in severe cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Enthesitis, and how does it relate to Psoriatic Arthritis?

A

Inflammation of the site where ligaments or tendons attach to bones. It is a common feature in Psoriatic Arthritis, often affecting areas like the Achilles tendon or plantar fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What conditions are associated with psoriatic arthritis?

A

Psoriasis
Cardiovascular disease
Gout
Psychological issues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which infections typically lead to reactive arthritis?

A

STI’s
Gastroenteritis - Salmonella, Shigella,
and Campylobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which cancer are patients with Sjogren’s syndrome at risk of?

A

B-cell (marginal zone) lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How does the pattern of joint involvement differ between rheumatoid and psoriatic arthritis?

A

Both have variable and overlapping joint involvement, but distal interphalangeal joint involvement is much more common in psoriatic than rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What demographic of patients are typically affected by pseudogout?

A

Elderly women

28
Q

What is Ankylosing Spondylitis (AS)?

A

A chronic inflammatory disease of the axial skeleton (vertebral joints) that can lead to partial or complete fusion and rigidity of the spine

29
Q

What is the genetic predisposition for Ankylosing Spondylitis?

A

HLA-B27 is present in about 90% of AS cases

30
Q

Who is most affected by Ankylosing Spondylitis?

A
  1. It is more common in males (~4:1 ratio)
  2. Typically presents between the ages of 20-40
  3. Onset often during late adolescence
31
Q

What are the hallmark articular symptoms of Ankylosing Spondylitis?

A
  1. Gradual onset of dull pain, especially in the spine and neck
  2. Morning stiffness lasting >30 minutes, improving with activity
  3. Late AS: loss of lumbar kyphosis with pronounced cervical lordosis
32
Q

What is Schober’s Test used for in AS?

A

Schober’s test measures lumbar spine flexion.

= A normal result should show an increase of more than 5 cm in the measured distance when the patient bends forward

33
Q

What is the hallmark X-ray finding in Ankylosing Spondylitis?

A

Bamboo spine

34
Q

What is the first-line pharmacological treatment for Ankylosing Spondylitis?

A

NSAIDS

35
Q

What are the ASAS classification criteria for diagnosing axial spondyloarthritis?

A

Criteria require ≥3 months of back pain and onset before age 45

+ either sacroiliitis on imaging and

(1) ≥1 SpA feature
(2) HLA-B27 positivity and ≥2 SpA features

36
Q

What are the surgical options in Ankylosing Spondylitis?

A

Mainly for hip and knee arthritis and is reserved for severe cases.

Kyphoplasty for spinal issues is controversial and carries significant risk.

37
Q

What is Enteropathic Arthritis?

A

IBD associated arthritis -

Inflammatory arthritis, involving the peripheral joints and sometimes the spine, occurs in patients with inflammatory bowel disease

38
Q

What gastrointestinal symptoms are common in IBD-associated arthritis?

A

Loose, watery stool with mucus and blood

weight loss

39
Q

What is the diagnostic finding in joint aspiration for IBD-associated arthritis?

A

No organisms or crystals

40
Q

What imaging modalities are used to diagnose sacroiliitis in IBD-associated arthritis?

A

X-ray or MRI

41
Q

What treatment leads to improvement in enteropathic arthritis?

A

Treating the underlying inflammatory bowel disease (IBD)

42
Q

A 21-year-old female presents to the rheumatology clinic with a 6-week history of joint pain, swelling and early morning stiffness affecting her left ankle and right knee. The pain is improved with movement. On further questioning, over the past few years, she has also been experiencing recurrent episodes of crampy central abdominal pain and diarrhoea, sometimes with blood in the stool and this has been especially bad during the last few weeks too.

What is the most likely cause of her joint pain?

A

Enteropathic arthritis

43
Q

Signs and symptoms of Enteropathic arthritis are what?

A

(1) Lower back pain

(2) Stiffness

(3) Localised pain in specific tendon insertion areas

(4) Transient joint inflammation

44
Q

Seronegative spondyloarthropathies should all be what?

A

RF and ANA negative

p-ANCA is seen in 55–70% of patients with ulcerative colitis

45
Q

When should coxibs be considered in place of NSAIDs?

A

When NSAIDs are needed, but there is a high risk of GI ulceration

46
Q

Enteropathic arthritis is a feature of which GI diseases?

A

Inflammatory bowel disease (either Crohn’s or UC)

47
Q

What are the differences between the clinical features of inflammatory and mechanical joint pain?

A

Inflammatory:
- Improves movement.
- Prolonged (>30 min) early morning stiffness.

Mechanical:
- Exacerbated by movement.
- Short early morning stiffness (<30 min).

48
Q

Which features would you expect to see on lumbar XR in a patient with ankylosing spondylitis?

A
  1. Squaring of the vertebrae
  2. Syndesmophytes
  3. A bamboo sign (late)
49
Q

What is reactive arthritis?

A

An infection-induced systemic illness characterised by inflammatory synovitis, where microorganisms cannot be cultured.

50
Q

What are the most common preceding infections for reactive arthritis?

A

Urogenital infections (e.g., chlamydia, Neisseria)

Entheogenic infections (e.g., salmonella, campylobacter)

51
Q

What gene is associated with reactive arthritis?

A

HLA B27

52
Q

What age group is most commonly affected by reactive arthritis?

A

Young adults, aged 20-40

53
Q

What are the main triggers of reactive arthritis?

A

Sexually transmitted infections (STI) or gastroenteritis

54
Q

When do symptoms of reactive arthritis typically appear?

A

1-4 weeks after the initial infection

55
Q

What type of arthritis is most common in reactive arthritis?

A

Asymmetrical monoarthritis or oligoarthritis

= often affecting a single large joint, like the knee

56
Q

What is Reiter’s syndrome?

A

A triad of urethritis, conjunctivitis/uveitis/iritis, and arthritis

57
Q

What investigations are used to diagnose reactive arthritis?

A

Increased inflammatory markers
Blood cultures
Urine/stool cultures
Joint fluid analysis
X-ray
Ophthalmology opinion

58
Q

What is the typical outcome of reactive arthritis?

A

Most cases are self-limiting, with 90% resolving spontaneously within 6 months

59
Q

What is the management for reactive arthritis?

A

Symptomatic relief → (IA/IM steroid injections)

Chronic cases → DMARDs may be needed

60
Q

What is the sex ratio for reactive arthritis?

A

M: F 9:1

(Compared to 3:1 for ankylosing spondylitis and 1:9 for SLE)

61
Q

What is the most common route of infection in Septic Arthritis?

A

The most common is haematological which means that the source of infection is coming from somewhere else in the body

62
Q

What is the management of patients with ankylosing spondylitis who have ongoing back pain despite using NSAIDs and following a regular exercise routine?

A

TNF-a inhibitors such as Infliximab

63
Q

Why is a joint aspiration done in a suspected diagnosis of Septic Arthritis?

A

Joint aspiration is done for two reasons;

(1) to remove all the infected fluid and to send the fluid for urgent Gram stain

(2) culture to determine the sensitivities and confirm the diagnosis

64
Q

What is the main differential diagnosis of diarrhoea in combination with arthritis?

A

Enteropathic arthritis (during arthritis)

Reactive arthritis (preceding arthritis)

65
Q

In Septic Arthritis, what is the recommended length of the oral antibiotic regimen?

A

At least 4 – 6 weeks (after at least 2 weeks of intravenous antibiotics)

66
Q

In Septic Arthritis, what is the recommended length of the intravenous antibiotic regimen?

A

At least 2 weeks

67
Q

What is the NHS Tayside empirical treatment for acute septic arthritis?

A

IV Flucloxacillin

Year 2- MSK (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions