Seronegative Arthritis Flashcards

1
Q

What are the features of the spondyloarthropathies?

A

An asymmetric arthritis involving the spine and associated with negative rheumatoid factor and HLA-B27

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2
Q

How is sero-negative rheumatoid arthritis classified?

A
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3
Q

What is the clinical and genetic basis for the grouping of sero-negative inflammatory arthritis?

A

Genetics:

  • HLA B27 gene is associated with Psoriatic Arthritis, intestinal arthropathies, ankylosing spondylitis
  • Negative rheumatoid factor
  • ANA

Clinical:

  • All spondyloarthropathies have a degree of sacroiliitis (inflammation of the sacroiliac joints)
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4
Q

What is the characteristic pattern of joint involvement in spondylo-arthropathies compared with other arthropathies?

A

Spondyloarthropathies have an asymmetric pattern of joint involvement compared to other arthropathies such as osteoarthritis

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5
Q

What are the characteristic features of Ankylosing spondylitis?

A
  • Question mark posture
  • Inflammatory back pain
  • Stiffness which improves with exercise
  • Bilateral sacroiliitis on X-rays
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6
Q

What are the characteristic features of enteropathic spondyloarthropathies?

A
  • IBD (Crohn’s or UC)
  • Peripheral or axial disease often present
  • Sacroiliitis
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7
Q

What are the characteristic features of Psoriatic arthritis?

A
  • Psoriasis (well-demarcated salmon-pink plaques with scaling)
  • Joint pain and stifness
  • Swelling of affected joints
  • Nail changes (yellowing, onycholysis, pitting and subungual hyperkeratosis)
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8
Q

What are the characteristic features of reactive arthritis?

A
  • Urethritis
  • Conjunctivitis
  • Uveitis/Iritis
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9
Q

What is Reiters syndrome?

A
  • Arthritis
  • Urethritis
  • Conjunctivitis
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10
Q

What is meant by the term spondyloarthropathy?

A

Any joint disease of the vertebral column

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11
Q

What are the extra-articular features of spondylarthritides?

A
  • Uveitis
  • Psoriasis
  • GI tract involvement
  • Aortic Regurgitation
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12
Q

What are the spondyloarthropathies?

A

Ankylosing spondylitis

Reactive arthritis

Psoriatic arthritis

Enteropathic spondyloarthropathies

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13
Q

With which disease are enteropathic spondyloarthropathies associated?

A

Crohn’s

UC

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14
Q

What is the epidemiology of ankylosing spondylitis?

A

Males

Onset in 2nd-3rd decade

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15
Q

What are the tests to assess spinal mobility?

A

Modified Schober

Lateral spinal flexion

Occiput to Wall

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16
Q

What are the extra-articular features of Ankylosing spondylitis?

A

1 - Uveitis

2 - Arthritis

3 - Psoriasis

4 - Crohns/UC

5 - HLA-B27

17
Q

How is ankylosing spondylitis treated?

A

1 - Physiotherapy

2 - NSAID’s

3 - DMARDS (Sulphasalazine)

4 - Anti-TNF

5 - Surgery

18
Q

What infections are associated with reactive arthritis?

A

1 - Salmonella

2 - Campylobacter

3 - Shigella

4 - Chlamydia