MSRA: Ank Spond, Behçet's + Reactive

Question 1

What are the associated features of Ankylosing Spondylitis?

Answer 1

Anterior uveitis
Aortic regurgitation
Achilles tendinitis
Apical pulmonary fibrosis
AV node block
And Cauda Equina symptoms

Question 2

What is the management of ankylosising spondylosis?

Answer 2

Exercise and physiotherapy
NSAIDs
DMARDs (if there is peripheral synovitis)
Anti-TNF treatment for axial disease

Question 3

What are the investigations in ankylosing spondylosis?

Answer 3

Bloods: CRP and ESR
Schober’s test for reduced forward flexion
X-ray spine - sacroilitis

Question 4

What are the features of reactive arthritis?

Answer 4

Can’t pee, can’t see, can’t climb a tree
Urethritis/cervicitis/balanitis
Conjunctivitis/anterior uveitis
Arthritis
Typically develops within 4 weeks of initial infection

Question 5

Which HLA is associated with Ankylosing Spondylitis?

Answer 5

HLA-B27 (positive in 90% of patients)

Question 6

Which organisms are commonly associated with reactive arthritis?

Answer 6

Salmonella
Shigella
Chlamydia
Campylobacter

Question 7

Which HLA is associated with Behcet’s Disease?

Answer 7

HLA-B51

Question 8

What are the features of Behcet’s Disease?

Answer 8

Oral ulcers
Genital ulcers
Anterior uveitits
DVT and thrombophlebitis