Seronegative Spondyloarthropathies Flashcards
What is the scoring system for joints?
DAS
Disease Activity Score
Which HLA relevant?
B27
What are all the 7 “As” of AS?
Anterior Uveitis Achilles tendonitis Apical fibrosis Aortic regurgitation Amyloidosis Atlanto Axial instability Autoimmune bowel disease (UC)
What are other extrarticular features of AS?
Dactylitis
Enthesis
Sacroilitis
Chest pain from fused ribs
What forms the AS posture?
?
lumbar lordosis
fixed kyphosis
What is the posture test?
Schobers
What are Xray signs of AS?
Dagger sign
Bamboo spine
Syndesmophytes
What is the initial presenting sign of AS?
Pain above buttocks in young men with insiduous onset
Sacral illitis
What is the management of AS?
NSAIDs- Naproxen or Diclofenac for 3 months max dose
Sulfasalazine
Adalimumab(can’t take alongside infection and infection prone)
Physio and hydrotherapy
Are steroids effective in AS?
NO
What scores are useful for monitoring AS?
BASDAI or BASFI
How do you image sacroilietis?
MRI T1 and T2
What are signature signs of all seroneg spondylos?
Sacroilietis, ethesitis, inflammatory back pain
What are 3 signs of reactive arthritis?
Cant see (uve)
cant’ wee (urethritis)
can’t climb a tree (arthritis)
How long does reactive arthritis last?
Months on and off
What joints are affected in reactive arthritis?
Any
Often lower limbs and achilles tendon swelling
What diseases cause reactive arthritis?
Campylobacter
Chlamydia
Salmonella
Shigella
What are skin lesions seen inreactive arthritis and descrive?
Keratoderma blenorrhagica
Waxy brown lesions on soles of feet and hands
Who do you need to liase with in reactive arthritis?
Opthalm
ID
Public health
What penis sing in reactive arthritis?
Circinate balanitis
How is reactive arthritis managed?
NSAIDs, skin and eyes treated with local steroids
If recurrent for over 6 months sulfasalazine
What radiological signs in reactive arthritis?
None
What % of patients with psoriasis have arthritis?
10
What % progress to deforming arthritis?
20
What hand signs are seen in psoriatic arthritis?
Onycholysis
Dactylitis
Telescoping of fingers
Pencil in cup on Xray
What are the 5 common presentations of Psoriatic arthritis?
DIP Asymmetrical oligoarthritis Symmetrical polyarthritis Spondyloarthopathies Arthritis mutilans (horrendous)
How is psoriatic arthritis managed?
NSAIDs
then add DMARDS methotrexate good for skin, or sulfsalazine
Adalimumab
What is used to assess PA?
PSARC
What rash do you get in enteric athritis?
Erythema Nodosum
Pyoderma gangrenosum
Sarcoidosis
Mouth ulcer
When do you get enteric arthritis?
IBD- peripheral and axial disease with occular disease and entethepathies
How does treatment of IBD affect arthritis?
Causes it to remit, but sacroileitis remains
