seronegative spondyloarthropathies Flashcards
seronegative spondyloarthropathies
male predominance
onset CD8 cells
TH17 response
Abs neg
spondyloarthropathies non vertebral symptoms
assymetric peripheral arthritis arthritis of toe IP joint sausage digits enthesopathy uveitis mucucutaneous lesions
ankylosing spondylitis
bamboo spine- brittle, ridgid SI inflammation/pain B/L increased kyphosis fatigue ocular inflammation, uveitis reduced rib expansion -> reduced inhalation weight loss possible atlantoaxial subluxation pulmonary fibrosis in upper lobes aortic insufficiency
ankylosing spondylitis labs
ESR- elevated RF- neg mild anemia HLAB27 x-ray SI b/l edema erosions
syndesmophytes
create bamboo spine
form laterally and posteriorly (if ant -> DISH)
shiny corner sign
types of psoriatic arthritis
oligoarthritis- most common SI asymmetrical DIP opera glass/arthritis mutilans- worst
labs of psoriatic arthritis
HLA-B27
RF and CCP neg
UA increased FE decreased
HIV associated
psoriatic arthritis Dx
psoriasis preceded arthritis in 80% - search for it
arthritis usually asymmetric with sausage fingers
unilateral sacrolitis
pencil in cup
may be assocaited w/uveitis, pleuritis, aortitis
reactive arthritis/reiters syndrome
follows infection seronegative asymmetric arthritis urethritis uveitis pustular psoriatic rash on palms and soles
venereal diseases that cause reactive arthritis
chlamydia
mycoplasma genitalium
ureaplasma urealyticum
enteric/GI infections that cause reactive arthritis
shigella salmonella yersinia campylobacter C. difficile
other infections that cause reactive arthritis
strep
HIV
other symptoms associated with reactive arthritis
enthesopathy (lovers heels) circinate balantis keratoderma blenorrhagicum oral ulcers sacroilitis carditis
IBD with arthritis
usually chrons
non-deforming asymmetric oligoarthritis that flares same time as GI symptoms
b/l and symmetrical SI as in ankylosing spondylitis
can have pyoderma gangenosum
monoarthritis
septic arthritis until proven otherwise
if pt has RA can be in multiple joints
group B strep or endocarditis can also be in more then one joint
what is most common inciting agent of septic arthritis
S. aureus
fitz-hugh curtis syndrome
when PID spreads causing perihepatitis
check for Cā deficiency
symptoms of disseminated gonorrhea
C' deficiency tenosynovitis pustules fever migratory polyarthralgias pancarditis
diffuse infiltrative lymphocytosis syndrome
seen in HIV b/c no CD4 cells and CD8 cells overactive attack salivary glands,mm, joints, nn, liver, kidnye. skin, lungs
Tx w/steroids and HAART
what can happen after you Tx diffuse infiltrative lymphocytosis syndrome in HIV pt
can get a rebound over activation of CD4 cells -> SARCOID
Tx w/ACE
erythema nodosum and arthritis
BUMPS: boecks sarcoid bechets disease UC/Chrons mycoses, mycoplasma pills streptococcus
