Seronegative Spondyloarthropathies: Ankylosing Spondylitis and Enteropathic Arthritis

Question 1

What are 4 seronegative spondyloarthopathies?

Answer 1

Ankylosing spondylitis (AS)
Enteropathic Arthritis
Psoriatic Arthritis
Reactive Arthritis

Question 2

What are 4 common features of Seronegative spondyloarthropathies?

Answer 2

seronegative
Sacroilitis
Anterior Uveitis
HLAB27+ (>92%)

Question 3

T/F: AS and Enteropathic Arthritis are virtually identical radiographically

Answer 3

True

Question 4

What is inflammatory spondyloarthropathy affecting sacroiliac jonts, vertebral column and the root joints (hips & shoulders)

Answer 4

AS

Question 5

Who is more prevalent to getting AS?

Answer 5

Males 3-9:1

Question 6

What are the clinical signs of AS?

Answer 6

LBP aggravated in supine position
limited chest expansion
peripheral enthesitis

Question 7

What is the key radiographic feature at onset of AS?

Answer 7

bilateral symmetrical sacroilitis

Question 8

What stage of AS is subtle SI erosion manifested by indistinctness of SIJ margins and pseudo-widening with reactive sub-chondral sclerosis primarily on the iliac side of the articulation?

Answer 8

Stage 1 of AS

Question 9

What stage of AS has more pronounced erosions on the iliac side. Marked reactive subchondral sclerosis?

Answer 9

Stage 2 of AS

Question 10

What stage(s) of AS has SI fusion and ankyloses, Ghost joints, and star sign?

Answer 10

Stage 3/4 of AS

Question 11

T/F: AS patients are at higher risk of cardiovascular disease

Answer 11

True

Question 12

What is it called when the patient has an inflamed eye with pain, photophobia, tearing, and blurred vision?

Answer 12

Anterior Uveitis

Question 13

Is anterior Uveitis less common or more common in HLAB27 patients?

Answer 13

Less common

Question 14

What leads to initial osseous erosion followed by fibrosis and ossification of connective tissue noted especially in the spine?

Answer 14

enthesitis

Question 15

T/F: AS begins with sacroiliitis and progresses to lumbosacral region gradually in ascending fashion involving the rest of the spine including cervical region and costotransverse & costovertebral joints of the chest

Answer 15

True

Question 16

What begins at the discovertebral junction and progresses to involve facet joints and inter and supraspinous articulations gradually involving the entire spine

Answer 16

Spondylitis

Question 17

What are the root joints that can be affected by AS?

Answer 17

Hips and shoulders

Question 18

What lesion is known as osteitis and enthesitis at the discovertebral attachment of annular fibers?

Answer 18

Romanus lesion

Question 19

What is known as the reactive zone of sclerosis?

Answer 19

Shiny corner

Question 20

In regards to marginal syndesmophytes, what radiographic sign is commonly accompanied by the dagger sign of the SPs?

Answer 20

Bamboo sign

Question 21

In regards to marginal syndesmophytes, what is the radiographic sign for facet and posterior ligament ossification?

Answer 21

Trolly-Track sign

Question 22

In regards to marginal syndesmophytes, what is the radiographic sign/lesion that has central end-plate erosions

Answer 22

Anderson Lesion

Question 23

What is the 2nd most common site for AS next to the hip?

Answer 23

Glenohumeral Joint

Question 24

What orthopedic test do you use to diagnose AS which evaluates lost flexion in the lumbar spine?

Answer 24

Schober’s test

Question 25

What are the 4 spinal complications of AS?

Answer 25

Ankylosis
Fractures
Canal stenosis
Dural ectasia (widening of dura)

Question 26

What are the etiologies of Enteropathic arthritis?

Answer 26

IBD: ulcerative colitis and crohn’s disease (most common)
Shigella
Whipple’s disease

Question 27

What are the clinical manifestations of Enteropathic arthritis?

Answer 27

Pain/stiffness after inactivity
Enthesitis of lower extremity
pyoderma gangrenosum (UC) and erythema nodosum
Uveitis