Seronegative spondyloarthropathy Flashcards
What are the general features of seronegative spondyloarthropathy?
Asymmetrical oligoarthritis, enthesitis, psoriatic skin, mucous membrane lesions, eye and bowel inflammation, HLA-B27 positive, rhematoid factor negative
What is the enthesis:
Sites where tendons/ligaments attach to bone
What is ankylosing spondylitis?
Chronic inflammatory condition of the spine and sacroiliac joints
Who done Ankylosing spondylitis mainly affect?
Male, 20-30 y/o
What are signs and symptoms of ankylosing spondylitis?
Back, neck and buttock pain Morning stiffness, improves with use Night pain Limited ROM in spine e.g. decreased lumbar flexion (schober's test) Anterior uveitis IBD
What do investigations show in ankylosing spondylitis?
Raised ESR/CRP
HLA-B27 positive
Imaging shows sacroilitis and ankylosis of SIJs
Bamboo spine and dagger sign due to vertebral body fusion by syndesmophytes
What is the management of ankylosing spondylitis?
Regular physio and exercise
NSAIDs or COX-2 inhibitors
PO/IV corticosteroids
Surgery for severe deformity
What are the signs and symptoms of psoriatic arthritis?
Dactylitis of fingers/toes
DIP involvement
Arthritans mutilans (osteolysis causes destruction and shortening in small joints)
Psoriatic nail changes e.g. pitting, onycholysis, hyperkeratosis
What is the management of psoriatic arthritis?
NSAIDs, DMARDs, Physiotherapy
What is reactive arthritis?
Aseptic autoimmune condition that occurs after a GU/GI infection
What are common GU and GI pathogens/infections for reactive arthritis?
GU: Chlamydia
GI: Shigella, Salmonella, Yersinia, Campylobacter
What is the common triad for reactive arthritis?
Conjunctivitis, Arthritis, Urethritis
How does reactive arthritis present?
Arthritis begins 1-3w after GI/GU infection
Asymmetrical oligoarthritis, mainly leg joints
How do you investigate reactive arthritis? What is the management?
Clinical diagnosis
ESR/CRP raised
May be HLA-B27 positive
Self-limiting so manage symptomatically
