Seronegative spondyloarthritides Flashcards

1
Q

What are some types seronegative spondyloarthritides?

A

Axial spondyloarthritis- ankylosing spondylitis is a subtype
Psoriatic arthritis
Enteropathic arthritis
Reiter’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the common features of seronegative spondyloarthritides?

A
RF -
Associated w HLA B27
Asymmetric 
Sacroilitis, spondylitis, enthesitis
Ant uveitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is axial spondyloarthritis?

A

Umbrella term

Chronic auto-inflammatory diseases affecting mainly the axial skeleton

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most known type of axial spondyloarthritis?

A

ankylosing spondylitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the presentation of axial spondyloarthritis?

A

Articular- inflammatory back pain, arthritis, enthesitis

Extra articular- ant uveitis, dactylics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What conditions are associated with axial spondyloarthritis?

A

Psoriasis
IBD
Restrictive lung disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the diagnostic criteria for axial spondyloarthritis?

A

> 3 months back pain with onset <45yo + 1 of

  • sacroilitis on XR and >1 feature
  • HLA B27 plus >2 features
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What investigations are done for axial spondyloarthritis?

A

RF, HLA B27
XR
MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the management of axial spondyloarthritis?

A
Rhysio
NSAIDs
DMARD= sulfasalazine
Anti TNF= infliximab 
Surgery- joint replacement, spinal surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Who is ank spond seen in?

A

Men, late teens to early 20s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the presentation of ank spond?

A
Inflammatory back pain
Enthesitis
Bilateral sacroilitis
Kyphosis
Ant uveitis
Dyspnoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the features of back pain in ank spond?

A
Insidious onset
Worse i morning
Improves with exercise 
Loss of lumbar lordosis
Can progress to complete fusion i.e. bamboo spine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What causes dyspnoea in ank spond?

A

Costochondral joit involvement limiting chest expansion

Apical pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the management of ank spond?

A

Physio and NSAIDs- generally good response

Biologic- Anti TNF- if 2 anti inflammatories have failed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is psoriatic arthritis?

A

Inflammatory autoimmune arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the presentation of psoriatic arthritis

A
Pain and stiffness- hot red and swollen over affected joints
Enthesitis- esp of achilles
Dactylitis
Psoriatic skin and nail changes 
PMH/FH psoriasis/psoriatic arthritis
17
Q

What joints are commonly affected in psoriatic arthritis?

A

DIP= characteristic
PIP, MCP and wrist
Sacroiliac joints

18
Q

What investigations are done for psoriatic arthritis?

A

Bloods- RF -, HLA B27, CRP and ESR

XR- pencil in cup and plantar spur deformities

19
Q

What is the management of psoriatic arthritis?

A
Physio 
NSAIDs
Steroids
DMARDs
Biologics 
Surgery
20
Q

What is reactive arthritis?

A

Sterile inflammatory arthritis that develops in response to distant infection

21
Q

What are the common causative organisms associated with reactive arthritis?

A

Chlamydia trachomatis= most common
Salmonella
Shigella
Campylobacter

22
Q

What is the presentation of reactive arthritis?

A

Reiter’s syndrome= arthritis, uveitis, urethritis/cervicitis
Arthritis= often knee or sacroiliac, 1-4 joints involved
Dactylitis
Enthesitis
Skin and mucous membrane involvement- keratoderma blenorrhagica, circulate balanitis

23
Q

What investigations are done for reactive arthritis?

A

CRP and ESR
HLA B27
XR
Aspiration

24
Q

What is the management of acute reactive arthritis?

A

Ongoing infection= antibiotics

NSAIDs

25
What is the management of chronic reactive arthritis?
NSAIDs | DMARDs- Sulfasalazine/methotrexate
26
What is enteropathic arthritis associated with?
``` Common= IBD Less= infectious enteritis, Whipple's disease, coeliac ```
27
What is the presentation of enteropathic arthritis?
Arthritis- often leg or axial spine, flares with bowel disease flares Enthesitis
28
What investigations are done for enteropathic arthritis?
ESR, CRP HLA B27 XR
29
What is the management of enteropathic arthritis?
NSAIDs Steroids Biologic- anti TNF- infliximab DMARDs- sulfasalazine/methotrexate