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MSK > Spondyloarthropathies > Flashcards

Spondyloarthropathies Flashcards

1
Q

What is the definition of spondyloarthropathy

A

a family of inflammatory arthritides characterized by involvement of both the spine and joints, mainly in genetically predisposed (HLAB27) individuals

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2
Q

What are the 4 subgroups of the spondyloarthropathies

A

Ankylosing spondylitis, psoariatic, reactive and enteropathic arthritis

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3
Q

What is HLA B27 associated with

A

ankylosing spondylitis, reactive arthritis, crohns and uveitis

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4
Q

What’s a typical description of mechanical back pain

A

Worsened by activity, typically worst at end of day, better with rest

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5
Q

What’s a typical description of inflammatory back pain

A

Worse with rest, better with activity, significant early morning stiffness - more than 30 minutes

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6
Q

What main joints are involved

A

Sacroiliac and spinal joints

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7
Q

What is enthesitis

A

inflammation at insertion of tendons into bones

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8
Q

What are some examples of enthesitis

A

Achilles tendinitis, plantar fasciitis

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9
Q

What is dactylitis

A

Inflammation of entire digit - sausage digits

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10
Q

What are some shared extra articular features of SA

A

occular inflammation (anterior uveitis, conjuctivitis), skin lesions, no rheumatoid nodules

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11
Q

What is a rare extra articular feature of SpAs

A

aortic incompetence or heart block

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12
Q

Sum up of ankylosing spondylitis

A

Chronic systemic inflammatory disorder, primarily affecting the spine

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13
Q

Who does AS affect and when does it come on

A

More common in men 3.5:1, comes in late adolescene/ early adulthood

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14
Q

Whats the two criteria used for SpA

A

ASAS Classification Criteria and Modified New York Criteria 1992

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15
Q

How come SpA is the A disease

A 
Axial Arthritis
Anterior Uveitis
Aortic Regurgitation
Apical fibrosis
Amyloidosis/ Ig A Nephropathy
Achilles tendinitis
Plantar Fasciitis
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16
Q

What are 3 main exam findings in SpA patients

A

Occiput to wall, chest expansion, Schobers test

17
Q

What are some features in a SpA Xray

A

Sacroilitis, syndesmophytes and ‘bamboo’ spine, shiny corners

18
Q

What are syndesmophytes and bamboo spine showing

A

the fusion of the spine - alters posture!!

19
Q

What is the best imaging to show early changes in SpA

A

MRI

20
Q

What is psoriatic arthritis (PsA)

A

Inflammatory arthritis associated with psoriasis, but 10 -15% of patients can have PsA without psoriasis

21
Q

What is arthritis mutilans

A

Really bad arthritis

22
Q

What are the clinical features of PsA

A

Nail involvement (Pitting, onycholysis)
Dactylitis
Enthesitis: Achilles tendinitis, Plantar fasciitis
Extra articular features (eye disease)

23
Q

What are the Xray features of PsA

A

Marginal erosions and “whiskering”
“Pencil in cup” deformity
Osteolysis
Enthesitis

24
Q

What is reactive arthritis

A

Infection induced systemic illness characterized primarily by an inflammatory synovitis from which viable microorganisms cannot be cultured

25
Q

When do symptoms of reactive arthritis show

A

1-4 weeks after infection

26
Q

What are the most common infections causing reactive arthritis

A

urogenital (chlamydia) and enterogenic (salmonella, shigella, yersinia)

27
Q

Who does reactive arthritis affect

A

Young adults (20-40)

28
Q

What is reiters syndrome

A

A form of reactive arthritis

29
Q

What is the triad for Reiters syndrome

A

Urethritis, conjunctivitis/uveitis/iritis, arthritis

30
Q

What are the clinical features of Reactive arthritis

A

Look on slides theres too many

31
Q

What must be ruled out in reactive arthritis

A

Septic arthritis, done by aspirating joint

32
Q

How goods the prognosis with reactive arthritis

A

Good, 90% resolve spontaneously within 6 motnhs - others need immunosuppresion

33
Q

What is enteropathic arthritis

A

Associated with IBD eg. Crohn’s, Ulcerative colitis- 9-20% patients with IBD

34
Q

Do symptoms get worse during flare ups of IBD

A

Yes they do

35
Q

What percentage of Crohn’s patients will have sacroilitis

A

20%

36
Q

What is the pharmacological treatments for SAs

A

NSAIDs, corticosteroids/ joint injections, topical steroid eyedrops, immunosuppressing drugs

37
Q

What are the non pharmacological treatments for SAs

A

Physio, OT, orthotics and chiropodist

MSK (14 decks)

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