Lec 8 Seronegative spondyloarthropathies Flashcards
What are the 4 types of seronegative spondyloarthropathies?
- ankylosing spondylitis
- psoriatic arthritis
- arthropathy of IBD
- reiters [reactive] arthritis
What are the unifying features of the seronegative spondyloarthropathies?
- asymmetric
- no RF
- associated with HLA-B27
- mostly in males
- axial skeleton involved
- DIP involved
- occurs at enthesis = where bones meat ligaments
What is HLA B27?
mediates antigen recognition by cytotoxic T cells
associated w/ seronegative spondyloarthropathies
What are clinical features of ankylosing spondylitis?
have chronic inflammatory disease of spine + sacroliliac joints –> ankylosis = stiff spine, due to fusion of joints
Who gets ankylosing spondylitis?
young men [mid to late 20s]
What do you see radiographically w/ ankylosing spondylitis?
bamboo spine
What non-spine symptoms in ankylosing spondylitis?
uveitis
aortic regurgitation/aneurysm
can lead to upper lobe pulm fibrosis
What is treatment of ankylosing spondylitis/
NSAIDs sulfasalzine MTX TNF inhibitors physical therapy
What are possible patterns of psoriatic arthritis?
5 different patterns —> spondylitis OR assymetric DIP involvement OR oligoarticular = > 4 joints OR polyarticular symmetric = looks like RA
What are clinical feat of psoriatic arthritis?
asymmetric and pathcy involvement
dactylitis of DIPs = sausage fingers
nail changes = yellow w/ pits
What do you see on xray in psoriatic arthritis?
pencil in cup deformity
What are classic causes of reactive arthritis?
GU –> chlamydia
GI –> shigella, salmonella, yersinia, campylobacter
What is classic triad of reactive arthritis?
- conjunctivitis
- urethritis
- arthritis
Does psoriasis cause rash on palms/soles?
nope!
What are two types of clinical syndromes of IBD arthropathy?
peripheral arthropathy [10-20%] –> migratory, assymmetric, oligoarticular
ankylosing spondylitis –> sacroilitis, spondylitis
