Seronegative Arthritis(Spondyloarthritis) Flashcards
What is spondyloarthritis?
Group of diseases characterised by inflammation of the spine and joints
->spondylitis=inflammation of spine
arthritis=inflammation of joints
Also just to note they are negative for the antibodies which are linked with rheumatoid arthritis (anti-CCP and rheumatoid factor)
Which gene may spondyloarthritis be associated with?
HLA-B27
->important to note that the presence of this gene is NOT diagnostic
Is spondyloarthritis/seronegative arthritis usually symmetrical or asymmetrical?
Asymmetrical most of time
Which part of the skeleton is involved in spondyloarthritis?
Axial skeleton
What are some of the extra-articular features of spondyloarthritis?
Uveitis- eye condition
IBD
Psoriasis- approx 10% of people w psoriasis develop an inflammatory arthritis
You have probs heard of ankylosing spondylitis but what is this now known as?
Axial spondyloarthritis
When does reactive arthritis occur?
Triggered by infection
What type of inflammation can many different types of spondyloarthritis all have?
Sacroiliitis
When is the onset of axial sponyloarthritis most common?
2nd to 3rd decade of life
Does axial sponyloarthritis affect more men or women?
Males > females
Axial sponyloarthritis is a chronic inflammatory disorder which affects which parts of the body?
Axial skeleton…get it from the name
Entheses- site of attachment of tendon, ligament, fascia, or capsule to bone.
Show is spinal mobility assessed?
Checking for spinal flexion/extension and measuring from spinal processes (clinical skills-to see if fingers move apart) or by using the Schober test involving a tape measurer
Lateral flexion too
What are the clinical features of axial sponyloarthritis?
Inflammatory back pain
Limited movements in anterior, posterior and lateral directions of lumbar spine
Limitation of chest expansion
(Relating to back pain)- Significant morning stiffness which get betters with movement
Night pain
Buttock pain
Increasingly more people are being diagnosed with non-radiographic axial sponyloarthritis.
What does this mean?
Their x-rays will look normal, inflammation is picked up on MRI scans
What are some other features that patients with axial sponyloarthritis may have?
Peripheral joint arthritis
Achilles tendonitis
Uveitis
Heart block
IBD
Osteoporosis
Cauda equina syndrome
Secondary amyloidosis
Management of axial sponyloarthritis?
Physiotherapy
NSAIDs
Short term steroids
DMARDs- both biologic and conventional synthetic
Sometimes surgery for joint replacements and spinal surgery
RECAP- which joint tends to be involved in rheumatoid arthritis?
MCP joints
Which joints tend to be affected by psoriatic arthritis?
Larger joints e.g. shoulder, elbow, knees, ankles
Smaller joints can be affected
People with psoriatic arthritis may not have any skin signs…what should be checked?
Nails for disease- pitting, etc.
There are many different subtypes of psoriatic arthritis, what tends to be the common?
Asymmetric oligoarticular arthritis
First line treatment for psoriatic arthritis>?
Methotrexate
Physio and OT input too
->good as treats the psoriasis and arthritisand IBD and uveitis which may be present too
Which infections can cause reactive arthritis?
Pretty much any infection
-but salmonella, campylobacter, chlamydia, streptococcal, Neisseria
What triad is indicative of Reiter’s syndrome?
Triad of arthritis, urethritis and conjunctivitis
Treatment for acute reactive arthritis?
NSAID
Joint injection
Antibiotics in some cases like chlamydia, in which contacts need antibiotics too
Treatment for chronic reactive arthritis?
NSAID
DMARD- e.g. methotrexate
Which conditions is enteropathic arthritis associated with?
IBD
Treatment of enteropathic arthritis?
Sulfasalazine
Steroids
Methotrexate
Anti-TNF
