Spondyloarthropathies Flashcards
what are spondyloarthropathies
inflammatory arthritides involving spine and joints, sero-negative meaning no rheumatoid factor
what gene is present in Spondyloarthropathies and what other conditions is it seen is
HLA B27, Crohn’s
what are the 4 Spondyloarthropathies subgroups
ankylosing spondylitis, psoriatic arthritis, reactive arthritis, enteropathic arthritis
what joints are commonly affected in Spondyloarthropathies
sacroiliac and spinal
what general features are present in Spondyloarthropathies
enthesitis (tendon), arthritis (asymmetrical), dactylitis (sausage fingers), occular inflamm
what is ankylosing spondylitis
verterbral discs fuse together, meaning it cant straighten out
who gets ankylosing spondylitis
men aged 20
what are the symptoms of ankylosing spondylitis
sacrioiliac joint pain, spinal morning stiffness that improves with exercise, no peripheral arthritis, shoulder and hip involvement
what are the 5 symptoms used in diagnostic criteria of increasing severity ankylosing spondylitis
limited lumbar movement, lower back pain for 3 months (not relieved on rest), reduced, reduced chest expansion, bilateral sacriolitis, unilateral sacroiliitis
what test can be done for ankylosing spondylitis
schober test
what imaging is used for ankylosing spondylitis
X ray and MRI
along side >3 months back pain and 45> age, what must be present to diagnose ankylosing spondylitis
sacroilitiis on imaging + 1 SpA feature OR HLA B2& positive + 2 SpA features
what 7 A’s are associated with ankylosing spondylitis
anterior uveitis, aortic valve involvement, apical pulm fibrosis, asymptomatic enteric mucosal inflamm, amyloidosis, achilles tendonitis, Atlanto-axial subluxation
how do you treat ankylosing spondylitis (mild - severe)
physio, NSAID’s, anti TNF eg infliximab (DMARDs if peripheral joint involvement)
what clinical features are there in psoriatic arthritis (7)
DIP involvement, multiple joints, sacroiliitis, dactylitis, nail pitting/ onycholysis, enthesitis, eyes
what tendons are affected in psoriatic arthritis
achilles and plantar fascia
how do you diagnose psoriatic arthritis
HISTORY + EXAM bloods: inflamm markers, X ray: osteolysis, enthesitis
how do you treat psoriatic arthritis (mild –> severe)
NSAIDs, steroid injections, DMARDs (methotrexate), anti TNFa if failed methotrexate
what is reactive arthritis
inflammation of synovium induced by infection - no infection in joint however
what infections commonly cause reactive arthritis
chlamydia, salmonella, shigella
what symptoms are present in reactive arthritis (7)
arthritis (pain, stiffness, function), Reiters syndrome, fever, fatigue, malaise, enthesitis, mucocutaneous legions
what is reiters syndrome
urethritis, uveitis, arthritis
what mucocutaneous legions can be present in reactive arthritis
nail dystrophy, keratoderma blennorrhagica (feet plaques), oral painless ulcers
how do you diagnose reactive arthritis
bloods: inflam, FBC, culture, joint aspiration, X ray
how do you treat reactive arthritis
AB’s, NSAIDs, DMARD’s steroids - can resolve spontaneously
what is enteropathic arthritis
associated with IBD, commonly affecting lower limb eh sacriolitis
what are the symptoms of enteropathic arthritis (6)
IBD symptoms (stools), weight loss, fever, uveitis, aphthous ulcer, enthesitis (achilles/ plantar fascia)
what invx are done for enteropathic arthritis
endoscopy, aspiration, inflamm marers, USS
how do you treat enteropathic arthritis (mild –> severe)
IBD treatment, analgesia, steroids, DMARDs, anti TNF (NSAIDs can cause peptic ulcers
