Seronegative arthritis Flashcards
what does seronegative arthritis mean?
Negative RF
What is ankylosing spondylitis?
Chronic inflammatory rheumatic disorder with preference for axial skeleton and entheses
Onset in 2nd or 3rd decade
males>females
AS clinical features
inflammatory back pain
limitation of movements in anteroposterior and lateral planes at lumbar spine
limitation of chest expansion
bilateral sacroilitis on x-rays
AS other features
Peripheral joints Achilles tendonitis Uveitis Aortic incompetence, heart block Restrictive disease IBD Osteoporosis and spinal fractures AAD and cauda equina Secondary amyloidosis
AS management
Physiotherapy NSAIDs DMARDs Anti-TNF ANTiI-IL17 Treatment of osteoporosis Surgery
Who gets psoriatic arthritis
M=F
peak 30-50 years
Nail pitting can be seen
Skin disease does not correlate with joint disease
What joints are commonly affected by psoriatic arthritis
Neck, shoulder, elbows, base of spine, wrists, all joints of knuckles, fingers and thumbs, knees, ankles all joints of toes
Psoriatic arthritis treatment
Sulfasalazine methotrexate leflunomide Cyclosporine Anti-TNF therapy Anti-IL-17 and 23 Steroids Physiotherapy and OT Axiald disease treated similar to AS
What is reactive arthritis?
Sterile synovitis after distant infection
infections include: salmonella, shigella, campylobacter, chlamydia trachoma’s or pneumonia
Infections from throat, urogenital and GI
Usually mono or oligoarthritis
What else is commonly effected in reactive arthritis
Urerthra
Conjuctiva
Iris
Soles of feet
What is Reiter’s syndrome
Arthritis, urethritis and conjuctivitis
What are prognostic signs for reactive arthritis
Hip/heel pain
High ESR
Family history and HLA-B27 positive
Treatment of reactive arthritis
Acute - NSAID, joint injection, antibiotics in chlamydia
Chronic - NSAID, DMARD
What is enteropathic arthritis
Commonly associated with IBD
Present with both peripheral and/or axial disease
Enthesopathy commonly seen
Treatment of enteropathic arthritis
NSAIDs difficult to use Sulfasalazine Steroids Methotrexate ANTI-TNF Bowel resection may alleviate peripheral disease
