Spondyloarthropathies Flashcards
What are spondyloarthropathies?
Group of conditions that effect the spine and peripheral joints
What conditions are spondyloarthropathies?
Ankylosing spondylitis
Enteropathic arthritis
Psoriatic arthritis
Reactive arthritis
What 7 features make spondyloarthropathies?
Sero negative HLA B27 associated Axial arthritis Asymmetrical large-joint oligoarthritis Enthesitis - inflammation of insertio site of tendon/ligament Dactylitis - inflammation of a digit Extra-articular manifestations
What is ankylosing spondylitis?
Chronic inflammation of spine and sacro-illiac joints
What gene is associated with spondyloarthropathies?
HLA B27
What is the presentation of AS?
Low back pain
- worse at night
Morning stiffness
What are the extra-articular features of AS?
Anterior uveitis Aortic incompetence AV block Apical lung fibrosis Amyloidosis
What are the x-ray features of AS?
Dagger sign - central radio dense line
Sacroilitis
Bamboo spine - vertebral body fusion
How is AS managed?
Regular exercise
NSAIDs
TNF-a inhibitors
What is psoriatic arthritis?
Form of arthritis that effects those with psoriasis
What are the features of psoriatic arthritis?
Oligo-arthritis with dactylitis
Psoriatic plaques
Nail changes
What is the management for psoriatic arthritis?
NSAIDs
DMARDs
TNF inhibitors
What is reactive arthritis?
Sterile synovitis following an infection
- dysentery (salmonella, shigella, campylobacter)
- urethritis (chlamydia)
What is the presentation of reactive arthritis?
Days - 2 weeks adter infection
Asymmetrical lower limb arthritis
Skin changes
- circinate balanitis
- keratoderma blennorhagica
Conjuctivitis
What is circinate balanitis?
Ring shaped dermatitis on penis
What is keratoderma blennorhagica?
Waxy skin lesions found on palms and soles
What is the management of reactive arthritis?
Treat infection
NSAIDs
Local steroid injections
What is enteropathic arthritis?
Inflammation of joints associated with IBD
What is type 1 enteropathic arthritis?
Oligoarthritis
Asymmetric
Correlation with IBD flares
What is type 2 enteropathic arthritis?
Polyarthritis
Symmetrical
Less correlation with IBD flares
How is enteropathic arthritis managed?
DMARDs
TNF inhibitors
