Seronegative Inflammatory Arthropathies Flashcards
(Males/Females) more commonly get ankylosing spondylitis
Males
What age range does ankylosing spondylitis typically present within?
20-40 years
Ankylosing spondylitis - typical presentation
What test can be used to assess lumbar spine flexion?
Chronic spinal pain and stiffness - worse in the morning and improves with exercise
May also develop knee/hip arthritis
Over time, loss of lumbar lordosis and exaggeration of thoracic kyphosis causes a question mark spine to develop
Schober’s test can be used to assess lumbar flexion
What other conditions is ankylosing spondylitis associated with?
Anterior uveitis
Aortitis
Pulmonary fibrosis
Amyloidosis
What will X-rays of the spine of someone with ankylosing spondylitis show?
Sclerosis
Fusion of the SI joints
Bony spurs from the vertebral joints (syndesmophytes) that can bridge the vertebral discs and cause a “bamboo spine” appearance
What HLA type are 90% of all those with ankylosing spondylitis positive for?
HLA-B27 positive
Ankylosing spondylitis - treatment
Physiotherapy and exercise
NSAIDs
Anti-TNF alpha therapy for more aggressive disease
(DMARDs typically have no effect on spinal disease, but may be useful for secondary joint inflammation)
What % of those with skin psoriasis go on to develop psoriatic arthritis?
Up to 30%
Psoriatic arthritis - presentation
Usually an asymmetric oligoarthritis, but may affect the hands in a similar manner to that seen in RA
Spondylitis, dactylitis (sausage digits) and enthesitis (site of tendon insertion into bone) commonly occur
Nail changes - pitting, onycholysis
What do 5% of patients with psoriatic arthritis go on to develop?
A particularly aggressive and destructive form of the disease called arthritis mutilans
Psoriatic arthritis - treatment
Similar to RA, typically involving DMARDs - methotrexate
Anti-TNF alpha therapy for those that don’t respond
What is Reiter’s syndrome?
What type of arthritis is it associated with?
Reiter’s Syndrome (Triad)
- Urethritis
- Uveitis
- Conjunctivitis
Associated with reactive arthritis (most commonly as a result of genitourinary or GI infections
In patients with inflammatory arthropathies, what HLA type is typically seen?
What is usually raised when taking bloods?
HLA-B27
CRP and ESR are typically raised
What conditions is enteropathic arthritis associated with?
Where does it present?
Affects the peripheral joints and sometimes the spine, typically asymmetric oligoarthritis
Seen in patients with inflammatory bowel diseases (e.g. Crohn’s or UC)
