Seronegative Spondylo's - Reactive Arthritis + IBD-related arthropathy

Question 1

Reactive Arthritis (aka Reiter’s syndrome);

Acute, ? lower limb arthritis occurring 4-? days following an infection, usually ?/? (infection may have been ?).
Common pathogens are ?, ? or ?.
o Ask about ? ? for atypical organisms.

Answer 1

asym
40
GI/GU
aSx
campylobacter
salmonella
chlamydia
foreign travel

Question 2

Reactive Arthritis (aka Reiter’s syndrome);

This can then develop into a ? arthritis.
More commonly affects ? (80% HLA B27 positive)
The joints themselves are ?, with the disease process due to ? stimulation of the inflammatory response (c.f. ? joint).

Answer 2

chronic
males
sterile
antigenic
septic

Question 3

Reactive Arthritis (aka Reiter’s syndrome);

Presentation;
o Classical triad : 'can' t ?, can't ? or climb a ?'
• ?itis.
• ?.
• ?-limb oligoarthritis.

o ?itis and ?itis may also develop in susceptible individuals

Answer 3

see
pee
tree

conjunctivitis
dysuria
lower

spondylitis
sacroiliitis

Question 4

Reactive Arthritis (aka Reiter’s syndrome);

Presentation
o ? is common.
• Often associated ? ? or ?tendonitis.
o ? lesions are common.
--> • ? ?: plaques similar to psoriasis.
• ? in the uncircumcised male.

Answer 4

enthesitis
plantar fasciitis
achilles
skin
keratoderma blenorrhagica
balanitis

Question 5

Reactive Arthritis (aka Reiter’s syndrome);

Management;
o Full dose ? +/- ? ?.
o ? is second line for more extensive disease.

Answer 5

nsaids
ster inj
sulfasalazine

Question 6

IBD-related arthropathy;
10-?% of those with IBD develop an arthropathy.
Presentation;
o Usually a ? arthritis affecting ? limb joints.
o 5% will also have ?/? involvement.
Can ? the IBD.

Answer 6

15
sym
lower
spinal 
SIJ
predate

Question 7

IBD-related arthropathy;
Remission of ? usually leads to remission of joint disease, but arthritis persists even in well-controlled ?.
Treatment is ?-related, with discussion between the ?
and ?.

Answer 7

uc
crohns
mdt
gastroenterologists
rheumatologists