Spondyloarthopathies Flashcards
How do you define spondyloarthopathies?
inflammatory arthritis involving both the spine and joints particularly in predisposed HLA B27 individual
Describe mechanical back pain (3 things)
worsened by activity, worse at end of day, better with rest
describe features of inflammatory pain (3 things)
worse with rest, better with activity, early morning stiffness
What is the most common involvement
spine and sacroiliac joint
what word describes inflammation at insertion of tendons into bones
enthesitis
what is dactyliitis
inflammation of entire digit
What extra articular features may be present in spondyloarthopathies
uveitis and conjunctivitis, lesions (mouth ulcers), part blcok
What is ankylosing spondylitis
chronic inflammatory disorder that primarily affects the spine- sacroiliac joint
at what age does ankylosing spondylitis occur
adolescent/ early adulthood
what are features that help diagnose AS
pain for more than 3 months, limited lumbar movement, decreased chest expansion, x ray
Which letter describes ankylosing spondylitis (7)
A- axial arthritis, anterior uveitis, aortic regurgitation, apical fibrosis, amyloidosis, achilles tendon, plAntar fasciitis
AS has cysts true or false
FALSE
Does AS have shiny corners?
Yup
How do you treat AS
physio, exercises, OT, NSAID, methotrexate (DMARD), Anti TNF, corticosteroid,
Inflammatory arthritis associated with psoriasis is what type of arthritis?
Psoriatic arthritis
Is rheumatoid factor positive or negative in psoriatic arthritis
negative
What features are shown in psoriatic arthrtitis
inflammation, sacroilitis, nail pitting, oncholysis, dactylics, enthesitits, eye disease
What would you see on an X-ray for psoriatic arthritis
erosions an whispering, osteolysis, enthesitis, pencil in cup deformity
How do you treat psoriatic arthritis
physio, OT, NSAIDS, corticosteroids, DMARDS
What is reactive arthritis
infection induced illness with inflmaatiory synovitis and organisms are present
When would you get symptoms in reactive arthritis
1-4 weeks after infection
what age group tend to get reactive arthritits
20-40
Is HLA B27 positive or negative?
positive
What is the triad that makes up reactive arthritis (reiters)
urethritis, conjunctivitis, arthritis
What are the features of reactive arthritis
systemic, asymmetrical arthritis, enthesitis, oral ulcers, nail, eye lesions, renal disease
How would you treat reactive arthritis
NSAIDs, corticosteroids, antibiotics, DMARDS, physio, OT
What GI problem is enteropathic arthritis associated with?
inflammatory bowel disease
True or false: Patients with UC commonly have sacroiliitis
false- its chrons!
What features would be present with enteropathic arthritis
bowel upset, WL, uveitis, skin, enthesitis, ulcers
What investigation would you do for enteropathic arthritis
endoscopy, aspirate joints, Xray, USS
How do you treat enteropathic arthritis
treat IBD first, analgesia, steroids, DMARDS, anti TNF