Seronegative Arthropathies Flashcards
What makes a seronegative arthritis?
Associated with HLA-B27 but RF -ve
Describe the general presentation of Seronegative arthropathies?
Generally Asymmetric
Involves spine
Common extra-articular features e.g. uveitis, enthesitis or IBD
Types of Seronegative Spondyloarthropathies?
Psoriatic Arthritis
Ankylosing Spondylitis
Enteropathic Arthritis
Reactive Arthritis
How is Psoriatic Arthritis Characterised?
By Dactylitis & Enthesitis along with nail pitting of psoriasis
Also look for a h/o or Fh/o Psoriasis
How is psoriatic arthritis treated?
DMARDs Cyclosporin Biologics (e.g. Anti-TNFalpha or Anti-ILs) Steroids Physio & OT
How is enteropathic arthritis characterised?
Peripheral or axial disease alongside IBD
How do we treat Enteropathic Arthritis?
DMARDs
Steroids
Anti-TNFalpha
NSAIDs
Bowel Resection (can help with peripheral disease)
Define Reactive Arthritis?
Sterile Synovitis following a distant infection (i.e. throat, urogenital or GI)
What infections commonly cause Reactive Arthritis?
Salmonella Shigella Yersinia Campylobacter Chlamydia Trachomatis or Pneumoniae Borellia Neisseria Streptococci
Whats special about Chlamydia induced Reactive Arthritis?
Often recurrent attacks rather than a single episode
How does Reactive Arthritis present?
H/o infection Involves skin & mucous membranes: - Keratoderma Blenorrhagica - Circinate Balanitis - Urethritis - Conjunctivits - Iritis
What is Reiter’s Syndrome?
A specific presentation of Reactive Arthritis:
- Arthritis + Urethritis + Conjunctivitis
how is reactive arthritis treated acutely?
NSAIDs & Joint Injection
IF Chlamydia give Abx
How is chronic reactive arthritis treated?
NSAIDs
DMARDS e.g. Sulfasalazine & methotrexate
Define Ankylosing Spondylitis?
A chronic inflammatory rheumatic disorder with predilection for axial skeleton and entheses
Probably the largest and most important Seronegative Spondyloarthropathy