Seronegative Arthritis (Spondylarthritis) Flashcards
Where in the skeleton is Spondylarthritis normally present?
Axial skeleton (spine)
What are 2 common extra-articular features of spondylarthritis?
Uveitis and IBS
Seronegative arthritis is an umbrella term for different clinical presentations, what are 4 of these conditions?
Ankylosing spondylitis
Psoriatic arthritis
Bowel related arthritis (Crohns)
Reactive arthritis
What is Ankylosing Spondylitis (AS) ?
A chronic inflammatory rheumatic disorder which mainly occurs in the axial skeleton.
When is Ankylosing Spondylitis onset ?
2nd-3rd decade of life
There is a greater instance of AS in males or females ?
In males
What is the blood test which is +ve in ~90% of patient’s with AS?
HLA-B27
What is the criteria used for the diagnosis of AS, what is this comprised of?
NY Criteria
Based on clinical and radio-graphic findings
What are some of the important criteria when diagnosing AS?
Limitation of spinal movements - especially in anterior-anterior movement.
Limitation of chest expansion
Bilateral sacroiliitis on x-ray
How is sacroiliitis graded?
0-4
0- Normal
4- Severe abnormality or total ankylosis
What are the 2 stages at which AS can be detected?
Non-radiographic stage:
- Back pain
- Sacroiliitis on MRI
Radiographic stage:
- Back pain
- Radiographic sacroiliitis
- Back pain caused by syndemophytes
What are the recommended treatment for AS?
PT NSAIDs DMARD (Sulfasalazine) Anti-TNF Anti-IL-17
How does reactive arthritis occurs?
From sterile synovitis after a distant infection such as: Salmonella Shigella Campylobacter Chlamydia Neisseria
What is Reiter’s syndrome?
Arthritis
Urethritis
Conjunctivitis
How is reactive arthritis characterized?
Recurrent attacks which are common in chlamydia-induced arthritis.
Prognostic signs for chronic reactive arthritis?
Heel/hip pain
High ESR
Family history
HLA-B27 positive
What is the primary treatment for acute reactive arthritis?
NSAIDs
Joint injection (if no infection)
Antibiotics (chlamydia infection)
What is the treatment for chronic reactive arthritis?
NSAIDs
DMARD (Sulfasalazine)
What is Enteropathic arthritis?
Associated with IBS
