Psoriatic and Reactive Arthritis

Question 1

What is a type of seronegative spondyloarthropathy that presents as a combination of erosive and productive asymmetric oligoarthritis mainly in the DIPs & PIPs?

Answer 1

Psoriatic Arthritis

Question 2

How often do patients get psoriatic arthritis if they already have psoriasis?

Answer 2

about 5%

Question 3

What are the 5 subtypes of Psoriatic arthritis?

Answer 3

Asymmetric oligoarthritis
Polyarthritis in DIPs
symmetric resembling RA
Spondyloarthritis
arthritis mutilans

Question 4

What is the most common subtype of the 5?

Answer 4

Asymmetric Oligoarthritis

Question 5

T/F: In regards to patients with psoriatic arthritis, HLA-B-27+ is in up to 60% especially in patients with sacroiliitis

Answer 5

True

Question 6

T/F: 80% cases with PsA will have psoriatic nail disease

Answer 6

True

Question 7

What is an important feature of PsA?

Answer 7

painful enthesitis at the Achilles and plantar fascia insertion

Question 8

What is the key Dx of psoriatic arthritis?

Answer 8

Morning stiffness and joint tenderness in asymmetrical distribution primarily in DIPs and PIPs

Question 9

What leads to Arthritis Mutilans and acro-osteolysis in some patients with PsA?

Answer 9

Bone erosions

Question 10

What is another name for Dactilytis?

Answer 10

Sausage digit

Question 11

What leads to periostitis, osseous sclerosis and thickening of tissues in the digits?

Answer 11

Proliferative process

Question 12

What are the 3 characteristics of Psoriatic nail disease?

Answer 12

Oil spots
Leukonychia (white spots)
distal onycholysis

Question 13

What are the radiographic features of PsA?

Answer 13

whispering and fuzzy bone formation

Mouse ears on distal tufts

Question 14

What is resorption of the distal bony phalanges called?

Answer 14

Acro-osteolysis

Question 15

Where are non-marginal syndesmophyte in PsA most commonly found?

Answer 15

thoraco-lumbar region

Question 16

What is a form of arthritis mutilans of the hand that causes shortening of the fingers due to destruction of the phalanges

Answer 16

Opera-glass hand

Question 17

What is defined as a triad of non-infectious urethritis, conjunctivitis and arthritis? (“Can’t see, can’t pee, can’t climb a tree”)

Answer 17

Reactive arthritis

Question 18

What is another name for Reactive arthritis?

Answer 18

Reiter syndrome

Question 19

How does reactive arthritis develop?

Answer 19

autoimmune response to infectious agent

Question 20

What is the prevalence of Male to female who get reactive arthritis?

Answer 20

Male 3:1

Question 21

T/F: HLA-B27+ immune histocompatibility complex is present in over 80%

Answer 21

True

Question 22

What are the 2 main immunological factors of Reactive Arthritis?

Answer 22

T2 Helper cells

HLAB27 molecules

Question 23

What are the target sites of Reactive Arthritis?

Answer 23

foot, calcaneus, ankles, and knees

Question 24

What are the radiographic features of Reactive arthritis?

Answer 24

enthesitis at insertion of achilles tendon and plantar fascia
retrocalcaneal bursitis
Juxtarticular osteoporosis

Question 25

T/F: In regards to spinal changes of reactive arthritis, bilateral sacroilitis and thoracolumbar non-marginal syndesmophytes are noted

Answer 25

T

Question 26

What is known as skin lesions commonly found on the palms and soles but which may spread to the scrotum, scalp and trunk with Reactive Arthritis?

Answer 26

keratoderma blennorrhagia

Question 27

What is inflammation of the glans of penis in regards to reactive arthritis called?

Answer 27

circinate balanatis

Question 28

What is an immune mediated triad of oral aphthous ulcers, genial ulcers and uveitis?

Answer 28

Behcet Disease

Question 29

What is the key diagnostic skin feature of Behcet Disease?

Answer 29

positive pathergy skin test