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CT > Seronegative Spondyloarthritis > Flashcards

Seronegative Spondyloarthritis Flashcards

1
Q

What is the definition of Seroneg Spondyloarthritis?

A
  • Arthritis often WITH HLA-B27 AND WITHOUT RF, ACPA, subQ nodules
  • Asymmetric peripheral, sacroilitis, enthesitis (tendinojoint junction), spinal stiffness
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2
Q

What is the key difference between RA and SS?

A

SS&raquo_space; inflammation starts at the enthuses

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3
Q

What is Ankylosis?

A

A stiffness of a joint due to abnormal adhesion and rigidity of the bones of the joint, which may be the result of injury or disease.

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4
Q

What is Dx for Anykylosing Spondylitis “stiff spine dz”?

A
  • 1 clinical + 1 imaging
    • Low insidious back pain > 3 months, that improves with exercise and is worst at 2 to 9 am, NSAIDs help
    • ↓ lumbar flexion
    • ↓ chest expansion
    • Sacroillititis imaging uni or bilateral
    • Acute anterior uveitis, enthesitis, peripheral arthritis
    Note: < 40 y/o onset with HLA-B27
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5
Q

What are physical exam findings for Ankylosing Spondylitis?

A

Schober’s (less spinal flexion)
FABER flexion,abduction, ext rotation (contralateral hip pain
Lordosis
High head to wall test (should be 0)

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6
Q

What are imaging findings of Ankylosing Spondylitis?

A
  • Syndesmophyte → “Shiny corners” osteitis due to inflammation at the site of insertion of the annulus fibrosus.
  • BAMBOO spine → ossification of annulus fibrosis
  • SI joint space narrowing (graded)
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7
Q

What are some extra-articular symptoms for AS?

< 20% association

A
  • Acute anterior uveitis
  • Aortitis, ↑ aortic root diameter
  • IgA nephropathy and amyloidosis
  • Pulm fibrosis
  • Cauda equina
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8
Q

What is Tx for AS?

A
  • NSAIDs
  • Sulfasalizine ==> morning stiffness
  • TNF ==> uveitis and bone
  • Prednisone ==> uveits only

MTX and DMARDs are NOT helpful

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9
Q

What is the definition of Reactive Arthritis?

A
  • sero-negative post-infectious (GI or GU) non-symmetrical arthritis in > Keratoderma Blenorrhagicum, Circinate Balinitis, and Uveitis
  • Can’t see, Can’t Pee, Can’t Bend a Knee
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10
Q

What are the Tx for Reactive Arthritis?

A
  • Antibiotics Only for chlamydia infections*
  • NSAIDS
  • Sulfasalazine
  • Methotrexate
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11
Q

What are the Arthritic patterns in Reactive Arthritis?

A 
o	Predominantly affecting the LE
o	mono to oligoarticular
o	Enthesitis
o	Dactylitis (sausage fingers)
o	Spondylitis
o	SI up to 50%
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12
Q

What is Reiter Syndrome?

A

Reactive Arthritis with a specific triad of symptoms: inflammatory arthritis of large joints, inflammation of the eyes (conjunctivitis or uveitis), and urethritis in men or cervicitis in women. Can’t See, Can’t Pee, Can’t Climb a Tree.

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13
Q

What is the definition of Psoriatic Arthritis?

A

Inflammatory joint pain found in five patterns + psoriasis or psoriatic nails, dactylitis in patients < 50 y/o

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14
Q

What are the five patterns of inflammation in psoriatic arthritis?

A 
DIP arthritis
Asymmetric oligoarthritis
Symmetric polyarthritis
Arthritis mutilans
Spondyloarthritis with asymmetric SI joint
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15
Q

What are the imaging patterns and common clinical findings of psoriatic arthritis?

A 
Dactylitis
Enthesitis
Psoriatic nails
Erosive arthritis
Bulky Syndesmophytes
Pencil in Cup phalanges
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16
Q

What is the Tx for psoriatic arthritis?

A
  • NSAIDs
  • Sulfasalazine, Methotrexate/leflunamide ==> skin and joint Tx
  • TNF alpha antagonists
  • Predinosone ==> can make psoriasis worse when stoping
17
Q

What is the definition of IBD-related Arthritis?

A

Asymmetric oligo or poly arthritis and symmetric SI arthritis, combined with IBD, erythema nodosum, and pyoderma gangrenosum

18
Q

What is erythema nodosum?

A

Erythema nodosum (EN) is an inflammatory condition characterised by inflammation of the fat cells under the skin, resulting in tender red nodules or lumps that are usually seen on both shins.

19
Q

What is Tx for IBD arthritis?

A 
Colectomy
Tx IBD
NSAIDs
Sulfasalazine
MTX/Leflunamide
TNFa ant
Adaliubumb
20
Q

Which Seroneg Spondylitis have
Symmetrical SI
Asymmetrical SI

A

Sym&raquo_space; Ank spond and IBD spond

Asym&raquo_space; React Arth and Psoriatic Arth

21
Q 
What are the common ages of onset of
Ank Spond
React Arth
Psoriatic Arth
IBD Arth
A

Ank Spond < 40 y/o
React Arth < 40 y/o
Psoriatic Arth < 55 y/o
IBD Arth = any age

CT (10 decks)

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