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MSK > Spondyloarthropathies > Flashcards

Spondyloarthropathies Flashcards

1
Q

Spondyloarthropathies

A

Any sero-negative arthritis that is characterised by the presence of tissue-type antigen HLA-B27

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2
Q

Spondyloarthropathies main issues

A

Back pain

Joint pain and swelling

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3
Q

Spondyloarthropathies Main area affected

A

Spine

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4
Q

Spondyloarthropathy associations

A

HLA-B27

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5
Q

Spondyloarthropathy sub-groups (4)

A

Ankylosing spondylitis
Psoriatic Arthritis
Reactive Arthritis
Enteropathic Arthritis

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6
Q

Inflammatory Back pain (5)

A

Onset is usually <35 years of age and is usually insidious.

Pain persists longer than 3 months (chronic)

Worsens with immobility

Pain/stiffness ease with physical activity

NSAIDs are very effective

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7
Q

Spondyloarthropathy Common Manifestations (8)

A

Enthesis (inflammation at insertion of tendons onto bones)

  • Plantar Fasciitis
  • Achilles tendonitis

Inflammatory Arthritis

  • Oligoarticular
  • Assymetrical
  • predominaantly lower limb

Sacroilitis

Spinal Involvement

Ocular Inflammation

  • Anterior uveitis
  • COnjunctivitis

Mucocutaneous Lesions

Aortic incompetence or heart block

No rheumatoid nodules

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8
Q

Ankylosing Spondylitis

A

Chronic systemic inflammatory disorder primarily affecting the spine

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9
Q

Ankylosing Spondylitis Hallmark

A

Sacroiliac involvement

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10
Q

Ankylosing Spondylitis Epidemiology

A

late Adolescents

Males

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11
Q

Ankylosing Spondylitis Classification

A

ASAS

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12
Q

Ankylosing Spondylitis Characteristics (7 A’s)

A 
Anterior Uveitis
Aortic Valve Involvement
Apical Pulmonary Fibrosis
Asymptomatic enteric mucosal Inflammation 
Amyloidosis
Achilles Tendonitits
Antalo-axial subluxation
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13
Q

Ankylosing Spondylitis Investigations

A 
Occiput/Tragus to wall
Chest Expansion
Schober's Test
Bamboo Spine on X-ray- advanced
MRI can show early stages
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14
Q

Ankylosing Spondylitis Treatment

A 
Physio
Occupational Therapy
NSAIDs
DMARDs
- Salazopyrin
-Methotrexate
Anti-TNF
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15
Q

Psoriatic Arthritis

A

Inflammatory arthritis associated with psoriasis

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16
Q

Psoriatic arthritis features

A

Sacroilitis (asymmetrical)
Nail involvement (pitting& onycholysis)
Enthesitis
Extra-articular-> Eye disease

17
Q

Psoriatic Arthritis Subgroups (5)

A

Psoriatic arthritis confined to DIPS

Symmetric Psoriatic Polyarthritis

Psoriatic Spondylitis

Asymmetric Psoriatic Oligoarthritis with dactylitis

Psoriatic Arthritis Mutilans

18
Q

Psoriatic Arthritis Main X-ray findings (4)

A

Marginal Erosions

pencil in cup deformity

Osteolysis

Enthesitis

19
Q

Psoriatic Arthritis Treatment

A 
Physiotherapy
Occupational THerapy
Orthotics
Podiatry
NSAIDs 
Corticosteroid Drug Injections 
DMARDs
-Sulfasalazine
-Methotrexate
-Leflunomide 
Anti-TNF
20
Q

Reactive Arthritis

A

Systemic illness induced by infection and characterised primarily by inflammatory synovitis

21
Q

Reactive Arthritis Aetiology

A

Urogenital
- Chlamydia

Enterogenic

  • Salmonella
  • Shigella
22
Q

Reactive Arthritis Epidemiology

A

20-40

Equal male to female ratio

23
Q

Reactive arthritis Features

A 
Reiters Syndrome
General Malaise
Fever
Fatigue
Asymmetrical mono arthritis or oligoarthritis
Enthesitis
Mucocutaneous Lesions
Keratoderma Blennorhagicum
Vesico-pustular waxy skin lesions 
Circinate Balanitis (dermatitis of glans penis)
24
Q

Reiters Syndrome (3)

A

Uveitis
Conjunctivitis
Arthritis

25
Q

Reactive Arthritis Diagnosis

A 
History and examination 
Bloods 
- Inflammatory markers (FBC, U&E, HLA-B27)
Cultures of blood,urine or stool 
Joint fluid analysis
X-ray of affected joints
Ophthalmology opinion
26
Q

Reactive Arthritis Treatment

A 
Most resolve spontaneously 
NSAIDs
Corticosteroids
Antibiotics 
DMARDs
-Salazopyrin
Physio
Occupational Therapy
27
Q

Enteropathic Arthritis

A

Arthritis associated with UC and Crohn’s disease

28
Q

Enteropathic Arthritis Common Sites

A 
Knees
Ankles
Elbows
Wrists
Spine
Hip 
Shoulder
29
Q

Enteropathic Arthritis Symptoms

A 
Loose watery stools (with blood and mucus)
Weight loss
Low-grade fever
Pyoderma Gangrenosum 
Enthesitis
Apthous Ulcers 
Arthritis in several joints
30
Q

Enteropathic Arthritis Investigations

A 
GI endoscopy
Joint aspirate
Raised inflammatory markers
X-ray/ MRI to show sacroilitis 
US - synovitis/tenosynovitis
31
Q

Enteropathic Arthritis Treatment

A 
Treat IBD
No NSAID use
Analgesia
Steroids
DMARDs
-methotrexate
-Sulfasalazine
-Azathioprine
Anti-TNF
-Infliximab
-Adalumimab

MSK (35 decks)

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