Spodyloarthropathies Flashcards
Features of spondyloarthropathies?
Seronegative RF negative HLA-B27 Axial arthritis ASymmetrical large joint arthritis Extra-articular manifestations
ANK SPOND
P
Chronic inflammatory disease of sacroiliac joints and spine
Fusion of vertebral bodies as the annulus fibrosis starts to calcify
Genetic/environmental
ANK SPOND CF
Dull back pain and stiffness > 6m
Worse at night and relieved by exercise
Reduced motion in lumbar and cervical spines
Lumbar lordosis
Schober’s test
Examined flexion of the spine - reduced
Achilles tendonitis
Plantar fasciitis
ANK SPOND Ix
X-rays
SI joint space narrowing/sclerotis/fusion
Bamboo spine = bony proliferations between ligaments and vertebrae with calcification
ANK SPOND Mx
Exercise not rest Intense physiotherapy NSAIDs Alpha blockers - etanercept Local steroid injections Surgical hip replacement
PsA P
Chronic inflammatory arthritis
Small joints of hand
Symmterical polyarthritis
Asymmetrical oligoarthritis
Spinal
PsA A
Psoriasis
HLA-B27
TRauma
PsA CF
Rheumatoid pattern
Asymmetrical oligoarthritis
Spondyloarthritis
DIPJ disease
DActylitis - sausage digits
Psoraitic rash
Nail changes - pitting, onycholysis, subungual hyperkeratosis
Uveitis
PsA Ix
X-ray
Pencil in cup deformity
PsA Mx
NSAIDs Sulfasalazine Methotrexate Steroid IA injections Physiotherapy Anti-TNFa
Reactive arthritis P
Acute aseptic arthritis in response to extra-articular infection from GI or GU tract
Bacterial GI or GU infection triggers asymmetrical oligoartritis 2-6w after initial infection
Reiter’s syndrome:
Can’t see, can’t pee, can’t bend a knee
Conjunctivitis bilateral, urethritis, arthritis
Reactive arthritis A
Male Chalmydia Post-dysentry HLA B27 20-40
Reactive arthritis CF
Asymmetrical oligoarthritis Iritis Keratoderma blenorrhagica Circinate balantitis Mouth ulcers
Reactive arthritis Ix
Raised ESR/CRP
Culture ctool
Sexual health review
Reactive arthritis Mx
Splint joints
NSAIDs
Steroids injections
DMARDs
