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MSK > seronegative arthritis > Flashcards

seronegative arthritis Flashcards

1
Q

what is seronegative arthritis (spondyloarthritis)

A

negative rheumatoid factor

may be assoc with HLA-B27

usually asymetric arthritis, bigger joints

axial skeleton

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2
Q

features of seronegative arthritis

A

enthesitis: inflammation of area where tendon/ligament attaches to bone

extra-aricular features: uveitis, IBD, psoriasis

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3
Q

different clinical presentations

A

ankylosing spondylitis
psoriatic arthritis
bowel related arthritis (crohn’s, UC)
reactive arthritis

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4
Q

ankylosing spondylitis

A

prototype for axial sponyloarthritis

chronic inflammatory rheumatic disorder with a predilection for axial skeleton and entheses

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5
Q

HLA B27

A

not diagnostic of AS/SpA

+ive in 90% of pts with AS

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6
Q

clinical features of ankylosing spondylitis

A 
inflammatory back pain, stiffness
uveitis
enthesitis 
sacroilitis 
aortic regurgitation 
AV node block
nerve entrapment 
uveitis
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7
Q

grading of radiographic sacroiliitis

A

0: normal
1: sus changes
2: minimal abnormality
3: unequivocal abnormality
4: severe - total ankylosis

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8
Q

managment of ankylosing spondylistis

A 
physiotherapy 
NSAIDs
DMARDs - sulfasalazine 
anti-TNF
anti-IL 12
treat osteoporosis 
surgery: joint replacements, spinal surgery
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9
Q

which joints more commonly affected psoriatic arthritis

A

large joints more than small

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10
Q

clinical subtypes of psoriatic arthritis

A

arthritis with DIP joint invovled
symmetric polyarthritis
assymetric oligoarticulararthritis

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11
Q

features of psoriatic arthritis

A

skin changes
nail changes
joint pain

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12
Q

treatment of psoriatic arthritis

A 
NSAIDs
sulfasalazine
methotrexate 
leflunomide
cyclosporin 
anti-TNF
anti-IL 17 and IL-23
steroids
physio + OT
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13
Q

reactive arthritis

A

sterile synovitis after distant infection

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14
Q

features of reactive arthritis

A

can’t see: conjunctivitis,
can’t pee: urethritis
can’t climb tree: arthritis, joint pain

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15
Q

prognostic signs for chronicity with reactive arthritis

A

hip/heel pain
high ESR
FHx and HLA-B27 +ive

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16
Q

management for reactive arthritis: acute

A

NSAID
joint infection (if infection exluded)
antib in chlamydia

17
Q

management for reactive arthritis: chronic

A

NSAIDs

DMARD e.g. sulfasalazine, methotrexate

18
Q

enteropathic arthritis

A

commonly assoc with inflammatory bowel disease

rarely seen w infectiou s enteritis, Whipple’s disease, coeliac

19
Q

features of enteropathic arthritis

A

can present with both peripheral and/or axial disease

enthesopathy commonly seen

20
Q

treatment of enteropathic arthritis

A 
NSAID (difficult w GI problems) 
sulfasalazine
steroids
methotrexate 
anti-TNF
bowel resection may alleviate peripheral disease

MSK (33 decks)

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