inflammatory extra Flashcards
what are blood test markers seen with SLE?
ESR elevated
+ ANA
+ RF
steroids used with SLE may lead to what clinically significant signs?
osteoporosis
AVN
spinal fractures
gastric ulcerations
what is the most frequent and serious complication of SLE?
kidney involvement leading to nephropathy and renal failure
What conditions can you see increased ADI?
JRA- most likely
RA
SLE- 8.5%
what conditions present with ulnar deviation?
SLE
Jaccouds
RA
What is the SLE distribution in the hands?
MCP and PIP MC
reversible ligament laxity- ulnar deviation
swan neck and boutonniere deformity
If a patient has ulnar deviation with minimal joint disease what is the most likely cause?
SLE
which disorder follows rheumatic fever, streptococcal pharyngitis and other CT disorders?
Jaccoud’s arthropathy
what presents with arthralgia, myalgia, weight loss, mitral valve disease?
Jaccoud’s arthropathy
With Jaccoud’s arthropathy there is no synovial pathology only _____ or _______
capsular fibrosis or DJD
scleroderma is the cutaneous manifestation of what disease?
progressive systemic sclerosis
dysphagia and heartburn are seen in 90% of patients with?
scleroderma
bowel sluggishness, distention, constipation and fibrosis in the lungs are seen with what condition?
scleroderma
calcinosis and acro-osteolysis are seen with which condition?
scleroderma
what is a chronic inflammatory disorder most commonly affecting young males primarily affecting the axial skeleton?
AS- chronic LBP in males
what condition is characterized by sequela of articular ankylosis, ligamentous ossification and enthesopathic changes?
AS
50% of AS patients will have peripheral disease especially affecting hips and shoulders, what is this called?
spondylitis rhizomelique
what percent of AS patients are + HLA-B27?
90%
how does AS typically affect the spine?
SI joint initially, then into the thoracolumbar jx, then lumbosacral and develops into ascending phenomenon
reactive sclerosis seen with AS is known as what radiographically?
shiny corner sign
corner erosions from reactive sclerosis seen in AS is known radiographically as?
romanus lesions
what is dagger sign?
interspinous ligament calcification- AS
what is trolley track sign?
z-joint capsular ossification- AS
what are vertically oriented spurs that are ossification of outer annulus fibers and inner ALL fibers?
syndesmophytes
vertebral body squaring is seen in?
AS
who does psoriatic arthritis typically affect?
10-15% of those with psoriasis
30-50 yrs old no gender bias
axial skeleton involvement in what percent of psoriatic arthritis?
20-40%
how does psoriatic arthritis usually present in hands?
asymmetrical small joint involvement, mostly DIP
mouse ears
pencil and cup
sausage digit
psoriatic mimics RA but is _____
less symmetric
spinal changes with psoriatic mimic AS but have ______
bulkier syndesmophytes and non-marginal
bilateral asymmetric
Reiters is usually caused by what?
STI-chlamydia
previous GI infection
usually 1-3 weeks post infection
what population is usually affected by Reiter’s?
males 15-35
what is the classic triad of Reactive arthritis?
conjunctivitis
urethritis
arthritis
though few demonstrate all 3
how does Reactive arthritis present in the SI joint?
asymmetric or unilateral
how does reactive arthritis present in the spine?
thick, non marginal syndesmophytes
what is lovers heel seen with reiters?
enthesopathy at plantar fascia and achille’s insertions into calcaneus; MTP also involved
sx before what age with CPPD are uncommon?
age 50
what are the metabolic disease associations with CPPD?
hemochromatosis hyperparathyroidism gout diabetes mellitus DJD
what are the 3 C’s of chondrocalcinosis?
Cartilage degeneration- DJD
Crystal deposition- gout CPPD
Cation disease- wilsons, hemochromatosis, hyperparathyroidism
when articular alterations occur secondary to cartilage degeneration what results?
pyrophosphate arthropathy
what is the MC genetic disorder affecting 1 in 300 people?
hemochromatosis- males 20:1 40-60
what is the triad seen in hemochromatosis
bronze skin
cirrhosis
diabetes
hooked osteophytes and chondrocalcinosis usually at MCP is seen in?
hemochromatosis
