Seronegative Arthritis Flashcards
What are the features of the spondyloarthropathies?
An asymmetric arthritis involving the spine and associated with negative rheumatoid factor and HLA-B27
How is sero-negative rheumatoid arthritis classified?
What is the clinical and genetic basis for the grouping of sero-negative inflammatory arthritis?
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)
What is the characteristic pattern of joint involvement in spondylo-arthropathies compared with other arthropathies?
Spondyloarthropathies have an asymmetric pattern of joint involvement compared to other arthropathies such as osteoarthritis
What are the characteristic features of Ankylosing spondylitis?
- Question mark posture
- Inflammatory back pain
- Stiffness which improves with exercise
- Bilateral sacroiliitis on X-rays
What are the characteristic features of enteropathic spondyloarthropathies?
- IBD (Crohn’s or UC)
- Peripheral or axial disease often present
- Sacroiliitis
What are the characteristic features of Psoriatic arthritis?
- Psoriasis (well-demarcated salmon-pink plaques with scaling)
- Joint pain and stifness
- Swelling of affected joints
- Nail changes (yellowing, onycholysis, pitting and subungual hyperkeratosis)
What are the characteristic features of reactive arthritis?
- Urethritis
- Conjunctivitis
- Uveitis/Iritis
What is Reiters syndrome?
- Arthritis
- Urethritis
- Conjunctivitis
What is meant by the term spondyloarthropathy?
Any joint disease of the vertebral column
What are the extra-articular features of spondylarthritides?
- Uveitis
- Psoriasis
- GI tract involvement
- Aortic Regurgitation
What are the spondyloarthropathies?
Ankylosing spondylitis
Reactive arthritis
Psoriatic arthritis
Enteropathic spondyloarthropathies
With which disease are enteropathic spondyloarthropathies associated?
Crohn’s
UC
What is the epidemiology of ankylosing spondylitis?
Males
Onset in 2nd-3rd decade
What are the tests to assess spinal mobility?
Modified Schober
Lateral spinal flexion
Occiput to Wall