Lecture 15 Seroneg Spondys Flashcards
seronegative spondyloarthropathies are characterized by a lack of ______ and by inflammation of bony insertions of tendons and fascia known as ____
rheumatoid factor, enthesopathy
what is strongly associated genetically with these disorders?
HLAB27 positive
Is HLA B27 an MHC1 or MHC2?
MHC type 1, presents to CD8 cells
What happened to the mouse that was injected with HLAB27?
developed characteristics of a human spondyloarthropathy
Triad of reactive arthritis/reiter syndrome:
conjunctivitis, urethritis, arthritis
diseases associated with development of reactive arthritis?
GI–shigella, salmonella, yersinia, campy
venereal–chlamydia
Where is the primary site of pathology in reiter’s, and what is the change in tissue characterized by?
insertion of ligaments/capsules into bone (enthesis)
fibrosis, ossification
do seronegative spondy’s typically affect men or women? what age?
men, young adults
What area of the body is typically affected?
spine
what disease is associated with the term “bamboo spine”
ankylosing spondylitis
major characterisitc of ankylosing spondylitis
low back pain of insidious onset
what seems to improve ankylosing spondylitits? is it worse during the day or at night?
exercise; night
There is often loss of lumbar ____ and stiffening of the spine with loss of ____
lordosis; motion
What does the schober test measure?
spinal distraction with bending
up to 80% of male patients with ankylosing spondylitis have this extraarticular symptom
prostatitis; (eye is often strongly involved-uveitis)
what cardiovascular disease is strongly associated with ankyl spondy?
aortitis
ankylosing spondylitis may cause fusion of the _____ joint
sacro-illac
Prognosis of ankyl spondy?
prognosis is good with regards to _____
bad with regards to _____
pain and function;
mobility
when does reiter’s syndrome typically present relative to illness?
2-4 weeks after
what is another name for dactylitis (as seen in Reiter’s and psoriatic arthritis)
sausage digit
Achilles tendonitis in reiter’s is also known as _____
lovers heel
Reiter’s: what is keratoderma blenorrhagica?
cobble stone skin lesions seeon soles, glans penis, and toes
reiter’s: what is circinate balanitis?
painless, superficial erosions of glans penis
Characteristic X-ray in psoriatic arthritis?
“needle in cup”
changes in what are often associated as a non-articular aspect of psoriatic arthritis?
nail changes
Psoriatic arthritis often has ‘____ ‘involvement, aka the involvement of all the joints on a digit
ray
____ ____ is the name of a severely destructive lesion can also cause ____ glass hands in psoriatic arthritis
arthilitis mutilans;
opera
____ digits can also be seen with psoriatic arthritis
telescoping
classic skin areas of psoriasis?
___ of the nails is also seen
periumbilical area, elbow;
pitting
Osteolytis with ____ ____ deformity is another name for the typical x-ray finding of psoriatic arthritis
fish tail
What general disease is also associated with arthritic symptoms?
inflammatory bowel disease
