Spondyloartopathies

Question 1

What are the main conditions of spondyloartropathies?

Answer 1

Psoriatic arthritis
Enteropathic
Ankylosing spondylitis
Reactive arthritis

Question 2

What is ankylosing spondylitis?

Answer 2

Chronic inflammatory disorder of the sacroiliac joints and spine

Question 3

What are the signs and symptoms of AS?

Answer 3

• Chronic low back pain
• with or without buttock pain
• Morning stiffness
• sleep disturbance
• onset before age 40
• relieved by exercise and worsened by rest
• enthesitis
• dactylitis
• Low grade fever
• anorexia
• malaise
• weight loss
• fatigue

Question 4

What is the criteria to be classified as having AS?

Answer 4

Back pain 3 or more months and age onset below 45
Sacroilitis on imaging

OR

HLA-B27 plus 2 or more features: 
Inflammatory back pain
Arthritis
Enthesitis
Uveitis
Dactylitis
Psoriasis
Crohns
Elevated CRP
Family history of SpA

Question 5

What is the treatment of AS?

Answer 5

First Line: Treat with NSAIDs with a PPI or COX-2 inhibitor

Second Line: DMARDs or Anti-TNF therapy