Rheumatology

Question 0

Name 5 diagnostic features of Ankylosing Spondylitis

Answer 0

Inflammatory backache
Plantar fasciitis
Uveitis
HLA-B27
MRI evidence of osteitis

Question 1

Name four seronegative spondyloarthropathies

Answer 1

Ankylosing Spondylitits
Psoriatic arthropathy
Enteropathic Arthropathy
Reactive arthritis

Question 2

Give me 6 common characteristics of seronegative spondyloarthropathies

Answer 2

Familial clustering
Rheumatoid factor negative
Asymmetrical arthritis - lower extremity
Extra-articular involvement - skin, mucosa, eye
Genetic background - HLA B27
Enthesitis & Sacroiliitis

Question 3

What are Entheses?

Answer 3

Specialized fibrocartilagenous region of bone where ligaments, tendons, fascia and joint capsules insert.

Question 4

What is Enthesitis?

And example

Answer 4

The central inflammatory unit of spondyloarthitis.

Entheses are infiltrated by T cells (enthesitis) producing bone erosions and heterotrophic new bone formation.

eg. Calcaneal spurs at insertion of plantar fascia.

Question 5

Name 2 proposed immune mechanisms for seronegative arthropathies

Answer 5

Post infectious

HLA-B27 molecular misfolding induces inflammation