Other Inflammatory Joint Diseases Flashcards
Jaccoud’s arthropathy follows what previous condition?
Rheumatic fever
What are the clinical presentations of Jaccoud’s arthropathy?
Non-erosive, reversible joint deformity with ulnar and fibular deviations
What GI issue is seen with Scleroderma patients due to a dilated esophagus?
Dysphagia and heartburn (90%)
What lung issue is seen in 100% of Scleroderma patients?
Fibrosis (only 25% will have symptoms)
What features make up the CREST syndrome seen with Scleroderma?
Calcinoshs Raynaud's phenomenon Esophageal dysmotility Sclerodactyly Telangiectasia
What population is likely to develop scleroderma?
Females ages 30-50
What lab results are associated with scleroderma?
Elevated ESR, +ANA, RF
What conditions are known as the Rheumatoid types (seropositive)?
RA, SLE, scleroderma, Jaccouds
Which conditions are known as the Rheumatoid variants (seronegative)?
AS, Reiter’s, psoriatic, enteropathic
What are the radiographic features associated with scleroderma?
1 distal tapering of soft tissues
2 subcutaneous soft tissue calcification
3 flexion contractures
What is the term for the terminal turf bony erosions associated with scleroderma and various other disease or possibly burns?
Acro-osteolysis
Instead of being positive for RF, what are the seronegative conditions positive for?
HLA-B27
Which conditions are HLA-B27+?
AS, psoriatic, reactive, and enteropathic
Ankylosing spondylitis primarily involves what general area of the skeleton?
Axial (SI and spine)
What is another name for AS?
Marie Strumpell’s Disease or Rhizomelic spondylitis
50% of AS patients will have what disease especially of the hips and shoulders?
Peripheral disease
What is the most common seronegative condition?
AS
What is the gender bias for AS?
Males
What is the #1 area for AS to target?
SI joints (bilateral symmetric involvement)
If a calcaneal spur is seen upon X-ray, what is the first condition that should be suspected? Second?
#1 = DJD #2 = AS
Which arthropathies are uniquely more common in men?
Reactive and AS
What is the usual age range for AS?
15-35
What are the lab results for AS?
HLA-B27+, +ESR (-RF and -ANA)
What are the common joint changes seen with AS?
Loss of subchondral definition, erosions and joint widening, fusion (50%)
What area of the SI joint specifically is targeted by AS?
Lower 2/3 due to synovial nature
What is the condition involving bilateral symmetric triangular sclerosis on X-ray near the bottom of the SI joints but only on the iliac side?
Osteitis Condensans Ilii
What causes the sclerosis seen with osteitis condensans ilii?
Mechanical stress across the SI joint
What population is more likely to have osteitis condensans ilii?
Multiparous females
What is unique about the patient presentation of osteitis condensans ilii?
No SI problems or symptoms!
Which sign of AS appears on X-ray as reactive sclerosis?
Shiny corner sign
Which sign of AS appears on X-ray as loss of anterior concavity of vertebral bodies?
Vertebrae squaring
Which sign of AS appears on X-ray as interspinous ligament ossification?
Dagger sign
Which sign of AS appears on X-ray as endplate destruction?
“Anderson lesion”
Which sign of AS appears on X-ray as a spinal fracture?
Carrot stick fracture
Which sign of AS appears on X-ray as thin syndesmophytes?
Bamboo spine
What is the “trolley track sign” indicative of?
AS: z joint capsular ossification
What is the MAJOR feature of AS of the spine on Xray?
Syndesmophytes
A fluffy enthesis can be seen with which condition?
AS
Enteropathic arthritis is radiographically similar to what other condition?
AS
Enteropathic arthritis is usually accompanied by which GI issues?
Ulcerative colitis and Crohn’s
What is the gender bias with enteropathic arthritis?
Isn’t one
How common is psoriatic arthritis?
5-7% of psoriatic patients
What population is likely to get psoriatic arthritis?
30-50 year olds (no gender bias)
What areas of the body are targeted by psoriatic arthritis?
HANDS*, feet, and axial skeleton
The immune reaction with psoriatic arthritis is similar to what other condition?
RA
Which joints are more commonly affected by psoriatic arthritis?
DIPS (like DJD)
What is the term for the central erosions of the phalanges commonly seen with PA?
Pencil-and-cup
“Cocktail sausage digit” is associated with which arthropathy?
PA
What is the difference between the syndesmophytes with PA and AS?
PA: thick, non marginal, random
AS: thin, marginal
Mouse ears periostitis is associated with what condition?
Psoriatic arthritis
What is the unique distribution of PA?
“Ray pattern” - more prominent along one digit than across joint type
What are the two conditions with periosteal reactions?
PS and JRA
Which is more symmetrical: AS or PA?
AS
What is the most likely cause of unilateral sacroilitis with lab results that are negative for HLA-B27?
Infection
What is the number one way in which reactive arthritis is different than PA?
Reactive loves feet; PA loves hands
What causes Reiter’s?
Previous infection in the body (GI or urinary or STD)
What is the triad associated with reactive arthritis?
Urethritis, conjunctivitis, and arthritis
What population is more likely to get reactive arthritis?
Males ages 25-35
What part of the body is targeted the most with reactive arthritis?
Knees, ankles, feet (lower extremities)
Keratoderma blennorrhagica is associated with which condition?
Reiter’s
