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Rheumatology > Seronegative arthritis > Flashcards

Seronegative arthritis Flashcards

1
Q

Shared clinical features of spondyloarthritides

A 
Seronegative 
HLAB27
Pathology in spine and sacroiliac joints
Enthesitis
Dactylitis
Extra articular manifestations
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2
Q

Definition of seronegative

A

Plasma negative for RF

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3
Q

Types of seronegative arthritis

A

Spondyloarthritis
Psoriatic arthritis
Reactive arthritis
Enteropathic arthritis

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4
Q

Difference between ankylosing spondylitis and spondyloarthritis

A

Called spondyloarthritis until radiological evidence of sacroiliac and spinal joint damage, then called ankylosing spondylitis

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5
Q

Describe ankylosing spondylitis

A

Chronic inflammation of spine and sacroiliac joints

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6
Q

Symptoms of ankylosing spondylitis

A

Gradual onset lower back pain radiating to buttocks and hips
Morning stiffness relieved by exercise
Worse at night
Progressive reduction in ROM in all directions

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7
Q

Associated symptoms of ankylosing spondylitis

A 
Anterior uveitis
Aortic regurgitation
Achilles tendinitis 
Apical lung fibrosis
AV block 
Costochondritis
Osteoporosis
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8
Q

How to test sacroiliac joints

A

FABER:
Hip flexion, abduction and external rotation

Positive if induces sciatic nerve irritation

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9
Q

Criteria to assess ankylosing spondylitis severity

A

BASDAI

BASFI

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9
Q

X-ray features of ankylosing spondylitis

A

Sacroiliac joint space narrowing or widening
Sclerosis
Erosions
Fusion
Dagger spine - fusion of spinous processes
Bamboo spine - fusion of vertebral bodies (calcification of ligaments)

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10
Q

Stepwise treatment for ankylosing spondylitis

A

First line: physio for spinal mobility
Second line: NSAID for 2 weeks, if not successful then try a different NSAID for 2 more weeks
Third line: TNF antagonist

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10
Q

When should you go straight to third line treatment in ankylosing spondylitis

A

BASDAI at least 4

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11
Q

Nail changes in psoriatic arthritis

A

Pitting
Horizontal ridges
Yellow discolouration
Nails curve upwards

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13
Q

Management of psoriatic arthritis

A

NSAIDs
Sulfasalazine
Methotrexate
Anti-TNF

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14
Q

X ray appearance of psoriatic arthritis

A

Pencil in cup deformity

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15
Q

Describe reactive arthritis

A

Autoimmune response to infection (typically GI or GU)

16
Q

Associated symptoms in reactive arthritis

A 
Iritis
Balanitis
Mouth ulcers
Enthesitis
Reiters syndrome
18
Q

Describe reiters syndrome

A

Urethritis - usually gonorrhoea
Uveitis or conjunctivitis
Reactive arthritis

19
Q

Management of reactive arthritis

A

Stool culture if diarrhoea
Sexual health review
Treat underlying infection if still present
NSAIDs
If symptoms >6 months try sulfasalazine or methotrexate

20
Q

Associations of enteric arthropathy

A

IBD
Gastric bypass
Coeliac disease
Whipples disease

21
Q

Management of enteric arthropathy

A

Treat underlying bowel symptoms (caution with NSAIDs)

Rheumatology (13 decks)

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