Seronegative Spondyloarthropathy Flashcards
spondylo
vertebra
ankylos
stiffening
seronegative means
RF
ANA
ANCPA
enthesis
site of attachment of tendon, ligament or joing capsule to bone; inflam here
key difference between RA w/ synovial inflam and SA is
inflammation starts at enthesis
enthesis is ___
metabolically active
4 types of arthridities taht dont equal RA
ankylosing spondylitis
reactive arthritis
psoriatic arthritis
inflammatory bowel disease arthrits
pattern of spondyloarthopathy
assymetric peripheral arthritis radiographic sacrolitis enthesitis absence of RA significant familial--HLAb27
Juvenile SA vs undifferentiated SA
juvenile- AS, ReA
undifferentiated- PsA, IBDA
definite AS dx
1 radiographic finding + > 1 clinical feature
pre-radiographic stage
undifferentiated axial spa
back pain
mri: active sacrollitis
radiographic stage AS
real AS
back pain, radigraphic sacrolitis–>ack pain + syndesmophytes
clinical features AS
back pain
low back pain with alternating buttock pain
slow onset, chronic
worse at 2-5 am, early morning
better with exercise nad nsaids, worse with exercise
most common extraspinal symptoms
eye-acute anterior uveitis aoritis-rare but very dangerous subclinical colitis pulmonary fiborsis Iga nephropathy, amyloidosis
why do you get pulmonary fibrosis
mechanical restriction–>decreased chest expansion
PE AS
occiput to wall distance >0
decrease spinal mobility, chest expansion
Shobers <15 cm
FABER-pain in contralateral SI joint is +
pelvic compression
early radiographic signs
shiny corners; romanus lesions
later radiographic signs
granulation inflammation
ossification of annulus–>syndesmophytes–>bridge and obliterate joint space–>bamboo spine
what marks severe sponylosis
PIP involvement
decreased surivial spond because
CVD
HLAb27
95% of patients have it, but only 5% of them develop HLAB27
if you have AS and are HLAb27, kids risk of getting it 20%
hlab27 negative associated with
later onset
Tx AS
nsaids, sulfsalazine
TNF alpha antag
effective for both axial disease and uveitis- aggressive
