OnlineMedEd: Rheumatology - "Seronegative Arthritis"

Question 1

True or false: the PAIR diseases often occur with ANCA.

Answer 1

False!

These are the SERONEGATIVE disorders!

Question 2

Why are the seronegative arthropathies unique among the autoimmune diseases?

Answer 2

• They affect men more than women.

* They are seronegative.

Question 3

Describe the presentation of ankylosing spondylitis.

Answer 3

• Commonly a male
• Affects the sacroiliac joint (stiff/painful back)
• Morning stiffness
• X-ray showing bamboo spine in advance cases

Question 4

How is the treatment of ankylosing spondylitis different from the other seronegative spondyloarthropathies?

Answer 4

DMARDs (like methotrexate) do not affect the axial skeleton so are not used.

Question 5

What nail sign is often seen in psoriatic arthritis?

Answer 5

Nail pitting

Question 6

Reactive arthritis is generally caused by _____________.

Answer 6

non-gonococcal STDs

Question 7

True or false: a joint aspirate will show high PMNs in someone with reactive arthritis.

Answer 7

False

Reactive arthritis is an autoimmune reaction to the joint, not a septic infection.

Question 8

When do you give antibiotics in reactive arthritis?

Answer 8

Only when you find an active infection (i.e., cervicitis, urethritis, esophagitis)

Question 9

When should you get a CT in those with ankylosing spondylitis?

Answer 9

When you suspect a back fracture not detected on x-ray