Seronegative Arthritis Flashcards
What are seronegative arthritides?
Seronegative arthritis’ describes a group of conditions that present with inflammatory arthritis but without a positive rheumatoid factor, hence seronegative.
With what gene is seronegative arthritis associated?
HLA-B27
What is enthesitis?
Enthesitis is inflammation of the entheses, the sites where tendons or ligaments insert into the bone.
What are the different types of seronegative arthritis?
Ankylosing Spondylitis Psoriatic arthritis Bowel related arthritis (Crohn’s, UC) Reactive arthritis Others
What is ankylosing spondylitis?
Ankylosing spondylitis (AS) is a chronic progressive inflammatory arthropathy.
What does AS present as?
Inflammatory back pain Iritis/uveitis Enthesitis Fatigue Sleep disturbance Tenderness at sacroiliac joint Dyspnoea Loss of lumbar lordosis Peripheral joint involvement Kyphosis Psoriasis Symptoms of inflammatory bowel disease Chest Expansion Limitation
What are the risk factors for AS?
HLA-B27 Klebsiella Pneumoniae FH Male Teens and twenties
What investigations should be done in AS?
CT MRI US HLA0B27 X-ray
What drugs are used to manage AS?
Physiotherapy NSAIDs DMARDs- Sulfasalazine Anti-TNF Anti-IL-17 Treatment of osteoporosis Surgery- joint replacements & spinal surgery
What is psoriatic arthritis?
Psoriatic arthritis is a chronic inflammatory joint disease associated with psoriasis. It is a seronegative inflammatory arthritis
What differentiates psoriatic arthritis from rheumatic arthritis?
These include a frequent oligoarticular or monoarticular initial pattern of joint involvement, as well as distal interphalangeal joint (DIP) involvement. Dactylitis, a fusiform swelling of an entire digit, and sacroiliitis are manifestations not observed in RA.
What drugs are used to treat psoriatic arthritis?
Sulfasalazine Methotrexate Leflunomide Cyclosporine Anti-TNF therapy Anti- IL-17 and IL-23 Steroids Physiotherapy and occupational therapy Axial disease treated similar to AS
What is reactive arthritis?
An inflammatory arthritis that occurs after exposure to certain gastrointestinal and genitourinary infections. The classical triad of post-infectious arthritis, non-gonococcal urethritis, and conjunctivitis is frequently described
What are the skin and mucous membrane involvement
Keratoderma blenorrhagica Circinate balanitis Urethritis Conjunctivitis Iritis
What is the treatment of reactive arthritis?
Acute
NSAID
Joint injection (if infection excluded)
antibiotics in chlamydia infection (contacts as well)
Chronic
NSAID
DMARD (e.g. sulphasalazine, methotrexate)
