spondyloarthropathies

Question 1

ankylosing spondylitis signs and symptoms

Answer 1

typically man <30
low back pain, worse at night, morning stiffness, better with exercise and improves during day
progressive los sof spinal movement
ethesitis - achilles tendon, plantar fasciitis
acute iritis

Question 2

investigations in ankylosing spondylitis

Answer 2

sacroilitis on x-ray
MRI - inflammation in joints of spine then eventually bamboo spine (fusion of vertebrae)
increased ESR, CRP, HLA-B27 positive

Question 3

enteric arthropathy

Answer 3

IBD
treatment of bowel symptoms
DMARD for resistant cases

Question 4

psoriatic arthritis

Answer 4

psoriasis now or previous or FH of it
symmetrical polyarthritis 
nail changes 
dactylics (synovitis) 
management: NSAIDs, sulfasalazine, methotrexate, ciclosporin, anti TNF agents

Question 5

reactive arthritis

Answer 5

can’t see can’t pee can’t climb a tree
arthritis, conjunctivitis, pain on urination
following infection most commonly GI and STI
some goes away some becomes chronic

Question 6

HLA-B27

Answer 6

5% of population are positive, some have no disease

ankylosing spondylitis
acuter anterior uveitis
reactive arthritis
enteric arthropathy
psoriatic arthritis