Inflammatory Spondyloarthropathy

Question 1

seronegative arthritis

Answer 1

inflammatory arthritis with RF negative serum

Question 2

5 Kinds of Serenegative spondyloarthropathy

Answer 2

• Ankylosing spondylitis (AS)
• Psoriatic arthritis (PsA)
• Reactive Arthritis (ReA)
• Inflammatory Bowel Disease (IBD - associated wtih enteropathic spondyloarthritis)
• Undifferentiates SpA

Question 3

HLA-B27 - what is it, meaning, pathogenesis

Answer 3

• MHC-I molecule - presents to CD8+
• its a genetic predisposition, still need trigger
• trigger thought to be an arthritogenic peptide? present peptide differently leading to arthritis
• Most ppl with HLA-B27 won’t get AS, but 95% of ppl with AS have HLA-B27 +

Question 4

Psoriatic arthritis - clinical features and worse prognosis

Answer 4

• asymmetrical, psoriasis, dactylitis
• pencil in cup
• nail pitting
• worse with:
  
  • high Sed rate
  • lack of response to NSAIDs
  • lack of range of motion in spin
  • dactylitis
  • onset before 16

Question 5

Radiographic findings in AS

Answer 5

• enthesitis - erosion oat tendon insertion
• bony spurs (enthesophyte)
• sacrolititis - - brdiging across joints
• discitis - ersosive changes at vertabral junction
• baboo spine
• osteoporosis

Question 6

Pathogenesis for AS

Answer 6

• inflammation at subchondral bone marrow and where tendon meets bone
• granulation tissue at sacroiliac join
• CD4, CD8, and macrophages at sacroiliac joint
• TNF
• HLA-B27+ linked to more serious disease

Question 7

Therapy for AS

Answer 7

old: NSAIDS, sulfasalazine, methotrexate

- new more effective - Anti-TNF drugs (like RA)