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
