Spondyloarthropathies basics and treatment Flashcards
what are the spondyloarthropathies
family of inflammatory arthritides characterised by involvement of both spine and joints
what are the different subgroups of the spondyloarthropathies (4)
ankylosing spondylitis, psoriatic arthritis, reactive arthritis, enteropathic arthritis
what gene is associated with the spondyloarthropathies, especially ankylosing spondylitis and reactive arthritis
HLA B27
describe the features of mechanical back pain
worsened by activity, typically worse at end of day, better with rest
describe the features of inflammatory back pain
worse with rest, better with activity, significant early morning stiffness(>30 mins)
what are the shared rheumatological features of the spondyloarthropathies
sacroilial and spinal involvement, enthesitis, inflammatory arthritis, dactylitis
what is enthesitis
inflammation at insertion of tendons into bones
what is dactylitis
inflammation of entire digits(“sausage” digits)
describe the features of the inflammatory arthritis seen in the spondyloarthropathies
oligoarticular, asymmetrical, predominantly lower limb
what are some shared extraarticular features of the spondyloarthropathies
occular inflammation, mucocutaneous lesions, rare aortic incompetence or heart block
what non-pharmacological treatment is used in spondyloarthropathies
physiotherapy, occupational therapy, orthotics, chiropidist
what is the first line pharmacological treatment for spondyloarthropathies
NSAIDs
what is used if NSAIDs are contraindicated in treatment for spondyloarthropathies
corticosteroids, can be injections if only few joints involved
what disease modifying drugs can be used in spondyloarthropathies and are useful for peripheral involvement
methotrexate, sulfasalazine, leflunomide
what drugs are used in severe spondyloarthropathy if patient not respondent to NSAIDs or methotrexate
anti-TNF (eg infliximab)
