Spondylitis

Question 1

Mention the 2 subgroups of axial spondyloarthropathies

Answer 1

. Ankylosing spondylitis
. Non-radiographic axial spondyloarthritis (nr-axSpA)

Question 2

HLA Haplotypes associated with Psoriatic arthritis

Answer 2

HLA B27

Question 3

HLA Haplotypes associated with ankylosing spondylitis

Answer 3

HLA B27

Question 4

What are the clinical tests used in assessment of ankylosing spondylitis?

Answer 4

. Cervical test
. FABER test
. Schober test
. Chest expansion test

Question 5

A patient recovered from an infevtion 2 weeks ago, he now presents with Reiter’s Triad (arthritis, urethritis,
conjunctivitis), what is the diagnosis?

Answer 5

Reactive arthritis

Question 6

Management of Peripheral spondyloarthropathies

Answer 6

• DMARDs (oral): MTX (PsA&Psoriasis, AS with peripheral arthritis, Ent,
ReA)
– SSZ (PsA without psoriasis, ReA, Ent, AS)
– LEF (PsA)
• NSAIDs:
• Steroids: intra-articular, systemic (po or IM)
• Biologics: - if failed or intolerant of 2 x DMARDs,
– Anti-TNF blockers (ETN*, HUM, IFN, GOL)
– Ustekinumab (IL-12,23 blockade): Psoriasis, PsA
– Secukinumab (IL-17 blockade): PsA, AS

Question 7

Management of axial spondyloarthropathies

Answer 7

• NSAIDs: first line in axial Treatment (AS / axSpA/ mild PsA)
• Biologics: - 2nd line after 2 x NSAID trial for Axial / AS.
– Anti-TNF blockers (ETN*, HUM, IFN, GOL)
– Ustekinumab (IL-12,23 blockade): Psoriasis, PsA
– Secukinumab (IL-17 blockade): PsA, AS
• No Role for Steroids and DMARDs