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Y2 Musculoskeletal > Spondyloarthropathies > Flashcards

Spondyloarthropathies Flashcards

1
Q

what gene predisposes to spondyloarthropathies?

A

HLA-B27

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2
Q

what are the four main spondyloarthropathies?

A

ankylosing spondylitis
enteropathic arthritis
reactive arthritis
psoriatic arthritis

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3
Q

describe mechanical back pain

A

worsened by activity
worse at the end of the day
improves with rest

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4
Q

describe inflammatory bakc pain

A

worse with rest
better with activity
significant early morning stiffness >30 mins

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5
Q

what is enthesitis?

A

inflammation at the insertion of tendons into bones

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6
Q

what is dactylitis?

A

inflammation of the whole digit

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7
Q

what eye problems can be seen in spondyloarthropathies?

A

anterior uveitis

conjunctivitis

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8
Q

what area is predominantly affected in ankylosing spondylitis?

A

the spine

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9
Q

when does ankylosing spondylitis tend to come on?

A

late adolescence or early adulthood

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10
Q

which sex is more commonly affected by ankylosing spondylitis?

A

males

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11
Q

what is the name of the criteria used to diagnose ankylosing spondylitis?

A

modified new york criteria
- AS if 4 or 5 met plus one other feature

OR

ASAS criteria

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12
Q

what are the five criteria in the new york criteria for diagnosis of ankylosing spondylitis?

A 
limited lumbar motion 
inflammatory back pain for three months 
reduced back pain 
bilateral, grade 2-4 sacroiliitis on XR
unilateral, grade 3-4 sacroiliitis on XR
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13
Q

when is ankylosing spondylitis diagnosed under the ASAS criteria?

A

sacroiliitis on imaging and >1 SpA feature

OR

HLA-B27 positive and >2 SpA features

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14
Q

what are the rheumatological features seen in ankylosing spondylitis?

A

back pain
enthesitis
peripheral arthritis is rare

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15
Q

what are the possible extra-articular features in ankylosing spondylitis?

A

anterior uveitis
fibrosis of upper lung lobes
enteric mucosa inflammation
amyloidosi s

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16
Q

what part of the cardiovascular system can be involved in ankylosing spondylitis?

A

the aortic valve

17
Q

what happens to the spine in ankylosing spondylitis?

A

vertebrae fuse and syndesmophytes form between vertebrae

18
Q

what tests can be done on clinical examination for ankylosing spondylitis?

A

tragus/occiput to wall
chest expansion
modified schober test

19
Q

what bloods should be assessed in ankylosing spondylitis?

A

inflammatory markers

HLA-B27

20
Q

what can be seen on x-ray of ankylosing spondylitis?

A

sacroiliitis
syndesmophytes
“bamboo spine”

21
Q

what nail features can be seen in psoriatic arthritis?

A

pitting

onycholysis

22
Q

what can be seen on x-ray of psoriatic arthritis?

A

marginal erosions and whiskering
pencil in cup deformity
osteolytes
enthesitis

23
Q

what is reactive arthritis?

A

infection induced systemic illness causing joint involvement

24
Q

when do symptoms occur in reactive arthritis?

A

1-4 weeks after infection

25
Q

what are the most common causes of reactive arthritis?

A

urogenital - chlamydia

enterogenic - salmonella, shigella

26
Q

who gets reactive arthritis?

A

young adults usually (20-40)

equal sex distribution

27
Q

what is reiter’s syndrome?

A

a form of reactive arthritis where urethritis, conjunctivitis/uveitis/iritis and arthritis are seen

28
Q

how does reactive arthritis present?

A 
fever, fatigue, malaise 
asymmetric mono/oligoarthritis 
enthesitis 
mucucutaneous lesions 
ocular lesions
29
Q

what is enteropathic arthritis associated with?

A

IBD

30
Q

what joints are affected in enteropathic arthritis?

A

patients usually have arthritis in several joints

especially knees, elbows, ankles and wrists

31
Q

when do symptoms of enteropathic arthritis get worse?

A

during IBD flare ups

32
Q

how does enteropathic arthritis present?

A

symptoms of IBD
uveitis
enthesitis

33
Q

what dermatological complication can be seen in patients with enteropathic arthritis?

A

pyoderma gangrenosum - associated with IBD

34
Q

what are the first line options for spondyloarthropathies?

A

NSAIDs

corticosteroid injections

35
Q

name three disease modifying drugs that can be used in spondyloarthropathies

A

methotrexate
sulfasalazine
leflunomide

36
Q

when is anti TNF given for spondyloarthropathies?

A

unresponsive to NSAIDs and methotrexate

Y2 Musculoskeletal (37 decks)

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