spondyloarthropathies

Question 1

what are spondyloarthropathies?

Answer 1

group of inflammatory rheumatic diseases that primarily affect the spine and peripheral joints

Question 2

what are the different types of spondyloarthropathies?

Answer 2

-ankylosing spondylities
-Psoriatic Arthritis
-Reactive Arthritis:
-Enteropathic Arthritis
-Undifferentiated Spondyloarthropathy

Question 3

how are spondyloarthropathies diagnosed?

Answer 3

-all rheumatological conditions are made with a clinical history supported by radiological investigations and blood tests

Question 4

my patient has back pain - how do I know its inflammatory?

Answer 4

-pain that docent settle after rest
-responds well to NSAIDS
-family history
-age (less than 40 yrs)
-morning stiffness (more than 30 mins)
-pain at night which may wake pt during second half of the night

Question 5

compare inflammatory back pain vs mechanical back pain

Answer 5

IBP
-age of onset (less than 40), -pain improves with exercise
- pain does not improve w/ rest
-morning stiffness (more than 30m)

MBP
-can happen at any age
-variable onset, may be acute
-pain may become worse w/ mvt
-pain often improves w/ rest

Question 6

what is HLA-B27?

Answer 6

a gene that is most associated with spondyloarthropathies

Question 7

what is axial pain?

Answer 7

pain in the lower back region

Question 8

what are the clinical symptoms of spondyloarthropathies?

Answer 8

-nocturnal pain (NB alternating buttock pain)
-early morning stiffness for more than 30 mins
-positive response to NSAIDS
-no improvement w/ rest
-tendon and joint pain
-often family history
-may also report fatigue, malaise and low grade fever

Question 9

what is ankylosing spondylitis?

Answer 9

-inflammatory joint arthritis primarily affecting the spine and the sacroiliac joints
-male more common than female

Question 10

describe the pathology of ankylosing spondylitis

Answer 10

-inflammation of the synovial and cartilaginous joints followed by partial or complete fusion of the joints

Question 11

what is syndesmophytes?

Answer 11

-reactive bone formation bridging between vertebral bodies

Question 12

what is enthesitis?

Answer 12

-inflammation where the tendon or ligament meets the bone

Question 13

where is enthesitis common?

Answer 13

-achilles
-plantar fascia
-patella
-gluteal

Question 14

what is uveitis?

Answer 14

when the middle layer of the eye (urea) becomes red and swollen

Question 15

what are the different outcome measures for ankylosing spondylitis ?

Answer 15

-BASDAI
-ASDAS-CRP
-ASAP app

Question 16

what should you assess in a physical exam for ankylosing spondylitis?

Answer 16

-observation - gait, posture, functional
-BASMI measure - lumbar flexion, cervical rotation etc
-chest expansion
-ROM
-strength
-palpation
-special tests etc
-exercise tolerance - consider impact on CVS system

Question 17

what are the recommendations of exercise for ankylosing spondylitis?

Answer 17

-more evidence for mobility -spinal, shoulders and hip - restoring normal range
-strength, balance, aerobic and functional exercise too

Question 18

what is psoriatic arthritis?

Answer 18

a form of inflammatory arthritis associated with psoriasis of the skin causing red rash skin on elbows, knees, back , buttocks etc
-unknown cause

Question 19

what is dactylitis?

Answer 19

inflammation of a digit - finger or toe

Question 20

what are the additional features of psoriatic arthritis other than psoriasis?

Answer 20

-tendon and joint pain - dactylitis
-very commonly affects DIP & PIP joints
-medium and large joint swelling

Question 21

what is reactive arthritis?

Answer 21

arthritis associated with an infection