Seronegative Spondyloarthropathies Overview

Question 1

Define seronegative spondyloarthropathy

Answer 1

inflammatory spinal condition negative for RF

Question 2

What are the 4 inflammatory spondyloarthropathies?

Answer 2

• ankylosing spondylitis
• enteropathic arthritis
• psoriatic arthritis
• reactive arthritis

Question 3

What is the most common inflammatory spondyloarthropathy?

Answer 3

ankylosing spondylitis

Question 4

What is the defining characteristic of seronegative spondyloarthropathies?

Answer 4

sacroiliitis

Question 5

Which inflammatory spondyloarthropathy(ies) have a bilateral symmetric pattern of sacroiliitis?

Answer 5

ankylosing spondylitis
enteropathic spondylitis

Question 6

Which inflammatory spondyloarthropathy(ies) have a bilateral asymmetric pattern of sacroiliitis?

Answer 6

psoriatic arthritis

Question 7

Which inflammatory spondyloarthropathy(ies) have a unilateral pattern of sacroiliitis?

Answer 7

reactive arthritis

Question 8

What is the only difference between ankylosing spondylitis and enteropathic arthritis?

Answer 8

presence of enterophathic disease
(identical in the spine)

Question 9

Which seronegative spondyloarthropathy favours the upper extremity?

Answer 9

psoriatic arthritis

Question 10

Which seronegative spondyloarthropathy favours the lower extremity?

Answer 10

reactive arthritis

Question 11

What areas of the spine do the seronegative spondyloarthropathies prefer?

Answer 11

• SI
• thoracolumbar junction
• may affect c/s

Question 12

What are the relevant lab findings for seronegative spondyloarthropathies?

Answer 12

• RF negative
• human leukocyte antigen-B27 (HLA-B27) positive
• ^ESR & CRP

Question 13

What gene is associated with seronegative spondyloarthropathies?

Answer 13

HLA-B27 protein on surface of WBCs make individuals more susceptible (need other features for Dx)

Question 14

In general, what age group is typically associated with all seronegative spondyloarthropathies?

Answer 14

20-40 yrs

Question 15

Inflammation of tendons and ligamentous attachments due to seronegative spondyloarthropathies causes _____ in the spine, and _____ outside of the spine/SI joints

Answer 15

syndesmophytes
enthesophytes

Question 16

Ankylosing spondylitis and enteropathic arthritis cause ____ syndesmophytes

Answer 16

marginal

Question 17

Psoriatic and reactive arthritis cause ____ syndesmophytes

Answer 17

non-marginal (AKA parasyndesmophytes)

Question 18

Ossification due to inflammation where the IVD attaches to endplates is called ____

Answer 18

syndesmophytes

Question 18

As opposed to RA, seronegative spondyloarthropathies like to result in ____ of joints

Answer 18

ankylosis (fusion)

Question 18

Ossification outside of the spine where ligaments attach to bone is called _____

Answer 18

enthesophytes

Question 19

What is the treatment for all seronegative spondyloarthropathies?

Answer 19

• low impact, regular activity (eg. yoga)
• anti-inflammatory diet (avoid milk, red meat)
• drug therapy (refer to rheumatology; NSAIDs early, DMARDs long term)

Question 20

Non-marginal syndesmophytes are also called ____

Answer 20

parasyndesmophytes