Psoriatic and reactive Arthritis Flashcards
Psoriatic arthritis typically presents following what skin condition
<10 years of Psoriasis
What are the presentations of psoriasis
Inflamed DIPJ Joints w/ -Onchylosis -Dactylitis -Enthesitis Psoriatic skin rash behind ears, scalp, nails and penile Artheritis Mutilans (Pencil in Cup)
What is the pencil in cup deformity
Osteolysis of bone =Shortening
Fingers telesocpe in on themselves
How can Psoriatic arthritis be treated
Symptoms = NSAIDs
DMARD = Methotrexate
Infliximab if methotrexate fails
Usfekinlimab iif Infliximab fails
What should be given to a patient with Psoriatic Arthritis If Methotreaxate and Infliximab fails
Usfekinlimab
Where do psoriatic skin rashes occur in patients with psoriatic arthritis
Behind ears
Scalp
Under nails
Penis
What is Reactive Arthritis
Sterile inflammation of synovial membrane and tendons in reaction to distal infection (STI)
What are the causes of Reactive Arthritis
Gastroenteritis (mc= c Jejuni)
STI (mc = Chlamydia)
What are the main presentations of Reactive Arthritis
Reiter’s Triad
- Cant see
- Cant pee
- Cant climb a tree
What is Reiter’s Triad
Uveitis
Urethritis/Balantis
Arthritis and Enthesitis
What is the main Differential for reactive arthritis
Septic arthritis
-Painful, hot swollen joint w/ infection Sx
How can Reactive arthritis be investigated
Joint Aspirate = MC+S =NO organism Light Microscopy = NEGATIVE Crystalopathy Raised ESR/CRP HLAB27 Positive Sexual health review
What would be found under a plane polarised light microscope for reactive arthritis
No Crystalopathy
Would any organisms be found in an MC+S of reactive arthritis
NO
How can reactive arthritis be managed
Symptoms =NSAIDs w/ Steroid injection
If recurrence in 6 months
-Methotrexate or Anti TNF Alpha