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DI 3203- Mod 9 > Seronegative Spondyloarthropathies > Flashcards

Seronegative Spondyloarthropathies Flashcards

1
Q

What are the 4 major seronegative spindyloarthropathies

A
  1. Ankylosing spondylitis (mc)
  2. Enteropathic spondylitis
  3. Psoriatic arthritis
  4. Reactive arthritis
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2
Q

What are the common features of seronegatives

A
  • strong association with HLA B27
  • Sacroiliatis
  • common site of entheses
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3
Q

What are the 3 major findings of sacroilitis

A
  1. Subchondral sclerosis (both side)
  2. Articular margins (blurry-iliac side first)
  3. Jt space (pseudowidening)
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4
Q

What portion of the joint does sacroilittis affect

A

lower 2/3 leading to eventual fusion

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5
Q

What will an MRI for sacroiliitis show

A

MRI will demonstate active inflammation before radiographic changes seen

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6
Q

Management of sacroilitis

A
  • Rheumatologist referal
  • comanage
  • avoud HVLA to inflamed jts*
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7
Q

AS- age, gender

A

mc seronegative

  • mid-late 20s
  • 3:1 M:F

Starts in SI jts

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8
Q

When you see bilateral symmetrical sacroiliitis what conditions should you think

A

AS first

Enteropathic spindylitis second

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9
Q

What is the steps of the pathological process to a marginal syndesmophyte (5)

A
  1. romanus lesion
  2. Shiny corner sign
  3. Squaring of VB
  4. Marginal syndesmophte
  5. (Fusion)
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10
Q

What is a romanus lesion

A

Inflammatory process that causes an erossion in sup ant corner of vert body

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11
Q

What is the shiny corner sign

A

Reactive sclerosis secondary to romanus lesion

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12
Q

What is squaring of vertebral body

A

Remodeling of the bone from erosions and healing over and over

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13
Q

what are marginal syndesmophytes and what else are they called

A
  • ossification of the annular fibers of the disc
  • fuses one vertebral segment with its adjacent vert seg

“bamboo spine”

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14
Q

What are ghost joints and what is it seen in

A

fusion of the SI joints

AS

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15
Q

What is the star sign and what is it seen in

A

Ossification of the interosseous lig

As

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16
Q

What is the railroad sign and what is it seen in

A

fusion of the lumbar facet jts

AS

17
Q

What is the dagger sign and what is it seen in

A

ossification of interpinous/supraspinous ligs

18
Q

What is a carrot stick fx and what is it seen in

A

fx of fused spine in AS

19
Q

What should u check in those with AS before HVLA

A

Check ADI

20
Q

Signs of enteropathic arthritis and what causes it

A
  • radiographically identical to AS

Association w inflammtory bowel disease (Chrons/ Ulcerative colitis)

21
Q

What lab tests are seen in enteropathic arthritis

A

+HLA B27 in 60-75%

ESR+ CRP elevated

22
Q

What % of pop have psoriatic arthritis and what % develop inflammatory arthritis

A

2-3% have psoriasis

-30-40% of psoriactic patients develop inflammatory arthritis

23
Q

What is the target area of psoriatic arthritis

A

Hands (Dips) > feet

Spine/SI

24
Q

side characteristic of psoriatic arthritis

A

Bilateral, asymetrical distribiton

25
Q

What radiographic signs will you see in the hands in psoriatic arthritis

A
  • MCPs, PIPs, DIPs
  • Ray pattern (affects all of one digit)
  • Erosions (mouse ears, pencil in cup)
  • Periostitis (whiskering)
  • Sausage digits
  • Acro osteolysis
26
Q

Signs of psoriatic arthritis in spine

A

sacroiliitis common
(asymetrical initially)

Non-marginal syndesmophytes

27
Q

What 2 conditions will have non marginal syndesmopytes

A

Psoriatic arthritis

reactive arthritis

28
Q

reative arthritis: clinical triad, age

A

Conjunctivitis, urethritis, arthritis

Secondary to STD/GI infection

29
Q

Reative arthritis in spine imaging

A

Radiographically identical to psoriatic arthritis

  • Sarcroiliitis (bilateral asymetric)
  • non marginal syndesmophytes
30
Q

What is enthesophyte (lovers heal) seen in

A

Reactive arthritis

31
Q

Sacroilliitis pattern of AS, ES, REA, Psoriatic

A

Bilat sym- AS, ES

Bilat aSym- ReA, Psoriatic

32
Q

What is osteitis condensans Illi due to/common in

A

Mechanical stress across the SI joint (during preg)

  • m/c in females
  • self limiting
33
Q

Radiographic findings of OCI

A
  • Triangular sclerosis along only the iliac side of SI
  • NO EROSIONS
  • bilateral symetricaal
34
Q

What is osteitis pubis (/findings)

A

Erosions of pubic bone (both sides)

  • subchondral sclerosis
  • irregular jt space

DI 3203- Mod 9 (10 decks)

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