Seronegative spondyloarthropathies Flashcards
1
Q
epi of ank spond
A
- strong assoc. with HLA-B27
- more in males
- loof for fam Hx of ank spond or psoriatic arthtirits
2
Q
onset of ank spond
A
- bilat. sacroilitis is required
- adol to young adult
- fusion of spine in ascending order
3
Q
9 clinical features
A
- low back pain and stiffness
- neck pain and limited cerv. motion
- enthesistis - esp . achilles
- get brittle spine with time and #s
- chest pain and less chest expansion
- shoulder to hip pain
- constitutional Sx
- eye involvment
- loss of normal posture as worsens
4
Q
3 Dx steps
A
- imaging of lumbar spine and pelvis
- high ESR - non-specific
- HLAb@7 not requireed
5
Q
4 Tx in increasing invasiveness
A
- NSAIDS
- PT
- surg
- immobilization if in trauma
6
Q
5 main seronegatives
A
- ank spond
- reactive arthritis
- sporiatic
- arthropathy of IBD
- undiff. spondyloarthropathies
7
Q
gen char. of reactive arth
A
- assymetric inflam oligoarthririts
- mostly HLAB27
- reiter syndrome common
8
Q
bugs associated with
A
salmonella, shigella, campylobacter, chlam, yersinia
9
Q
triad of reiters
A
- occular inflammation - can’t see
- urertritis- can’t pee
- arthritis - can’t climb a tree
10
Q
clin features of reactive
A
- GI or GU infection 1-4 weeks before
- assymterig oligoarthritis
- fatugue, malaise, weight loss
- joint pain may persist over time
11
Q
3 Tx of reactive
A
- NSAIDS first line
- sulfa
- not usually ABx
12
Q
Char of psoriatic artritis
A
- less than 10% of PT with psoriasis
- gradual in onset after years
- usually assymetric and polyarticular
- upper extremities and small joints more common
- NSAID initial, then follow RA Tx
