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MSK AM > Seronegative arthritis > Flashcards

Seronegative arthritis Flashcards

1
Q

What are the classical features of seronegative arthritis?

A 
Negative rheumatoid factor
Associated with HLA-B27
Assymmetric
Axial skeleton involvement
Enthesitis
Uveitis and IBD
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2
Q

What is enthesitis?

A

Inflammation of tendon insertion to bone

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3
Q

What are the types of seronegative arthritis?

A 
Ankylosing spondolysis
Psoriatic arthritis
Bowel related arthritis
Reactive arthritis
Others
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4
Q

How is axial spondyloarthritis classified?

A

Patient with >3 month history back pain and onset <45 years

Sacroilitis on imaging plis >1 SpA feature OR HLA-B27 plus >2 SpA features

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5
Q

What are the clinical features of axial spondyloarthritis?

A 
Inflammatory back pain
Arthritis
Enthesitis
Uveitis
Dactylitis
Psoriasis
Crohn's/UC
Pulmonary- restrictive disease, apical fibrosis
Neuro- AAD, cauda equina syndrome
Secondary amyloidosis
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6
Q

What is ankylosing spondolysis?

A

Chronic inflammatory rheumatic disorder with predilection for axial skeleton and entheses

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7
Q

Who is ankylosing spondolysis seen in?

A

2nd to 3rd decade

Males > females

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8
Q

What are the clinical features of ankylosing spondolysis?

A

Inflammatory back pain
Limitation of movement in anterior-posterior and lateral planes
Limitation in chest expansion
Bilateral sacroilitis on xray

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9
Q

What investigations are done for ankylosing spondylitis?

A

Xray

MRI

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10
Q

What is the management of ankylosing spondolysis?

A 
Physio
NSAIDs
Sulfasalazine
Anti TNF
Terat osteoporosis
Surgery- joint replacement, spinal surgery
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11
Q

What are the commonly affected joints in psoriatic arthritis?

A

C and L spine
Shoulder, elbows, wrists, fingers
Knees, ankles, toes

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12
Q

What are the clinical features of psoriatic arthritis?

A

Inflamed, stiff painful joints
Normally overlain by psoriasis
DActylitis
Enthesitis

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13
Q

What is the treatment of psoriatic arthritis?

A 
Physio
OT
Sulfasalazine
Methotrexate
Cyclosporin
Steroids
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14
Q

What is reactive arthritis?

A

Sterile synovitis after distant infection

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15
Q

What are the causative infections of reactive arthritis?

A 
Salmonella
Shigella
Campylobacter
Chlamydia
Borrelia
Neisseria
Streptococci
Pneumoniae
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16
Q

What are the clinical features of reactive arthritis?

A 
Usually affects 1-4 joints
DActylitis
Enthesitis
Skin and mucous membrane involvement
Reiter's syndrome
17
Q

What are the features of skin and mucous membrane involvement in reactive arthritis?

A 
Kertoderma blenorrhagica
Circinate balanitis
Urethritis
Conjunctivitis
Iritis
18
Q

What is the acute treatment of reactive arthritis?

A

NSAIDs

Antibiotics for joint infection

19
Q

What is the chronic treatment of reactive arthritis?

A

NSAIDs

Sulfasalazine or methotrexate

20
Q

What is enteropathic arthritis associated with?

A

Most common- IBD

Rarely infectious enteritis, Whipple’s and coeliac

21
Q

What are the clinical features of enteropathic arthritis?

A

Peripheral and/or axial disease

Enthesopathy

22
Q

What is the treatment of enteropathic arthritis?

A

Sulfasalazine or methotrexate
Steroids
Anti TNF

MSK AM (37 decks)

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