SPAs Flashcards
What is the most common inflammatory disorder of the axial skeleton?
AS
How do patients with AS describe their morning stiffness improvement?
What are 3 extra articular manifestations?
Improves with exercise, worse with rest
Uveitis, tendonitis (especially Achilles), and aortitis
What are the 3 special tests to do for AS and what would be positive tests?
Faber, so cant flex, abduct and ER at hip
Schober, forward flexion test of lumbar spine shows restriction if less than 4cm
Chest expansion test is positive if less than 5 cm
What type of imaging are we doing for AS, what are we looking for, and what two things will we see as far as abnormalities?
AP view of pelvis and SI
Looking for bilateral SI joint changes like erosions or ankylosis
Squaring (loss of anterior convexity)
Shiny corners (sclerosis of v bodies)
What is CT more sensitive for when looking at AS?
Erosions
4 symptoms of cauda equina syndrome?
2 late complications?
Back pain, radiation pain down leg, numbness in perineum, loss of bowel or bladder control.
Restrictive lung disease and compression fractures
5 key points of AS to remember/keep in mind?
Age of onset before 40 Gradual onset Am stiffness and reduction in l spine flexion Improvement with exercise Positive family history
4 things to treat AS?
Any type of exercise/physical activity
NSAID
TNF blockers
Non bio DMARDS, but only limited to peripheral joints, doesn’t not work centrally
What clinical manifestation can be present with sexually active reactive arthritis?
What can be present on soles and palms with reactive arthritis?
4 big picture clinical signs of reactive arthritis?
Circinate balanitis, infection of penis head
Keratodermia blennorrhagica, painless eruptions
Arthritis, conjunctivitis, urethritis, and oral ulcers
Treatment for reactive arthritis, 4 things?
- Usually self limiting in about 6 months
- NSAID and steroids
- If chronic, use DMARDS
- Is urethritis from chalamydia, aziththromycin or doxycycline
What type of arthritis is associated with pitting of the nail?
DIP arthritis
3 step progression of DIP arthritis in psoriatic arthritis?
- Narrowed joint space with erosions
- Reactive subperiosteal new bone
- Pencil in cup appearance
4 treatment options for peripheral arthritis?
Non bio DMARDS are used for what part of the body?
NSAIDS, DMARDS, TNF blockers, combo methotrexate with TNF
Peripheral joints
How do we characterize enteropathic arthritis?
4 features to remember?
Arthritis associated with IBD so Crohns or UC
The arthritis parallels the IBD
Large joints in the lower extremity are affected
Small joints in the upper extremity are affected
CD show much more extra articular manifestations
Extra articular manifestations?
Pyoderma gangrenous
Erythema nodosum
Uveitis
