Seronegative Spondyloarthropathies

Question 1

Seronegative Spondyloarthropathies - General

Answer 1

Multifactorial (Genetic + Environment [infx])
Immune Mediated triggered by T-Cell
Inflammatory Oligoarthritis and Enthesopath
HLA-B27
Triggering Infecttion
No specific autoantibodies
Eyes, Skin, Cardio Involvement

Question 2

Seronegative Spondyloarthritis - Types

Answer 2

1. Ankylosing Spondyloarthritis
2. Reactive Arthritis (Reiter Syndrome/Enteritis Associated
3. Psoriatic Arthritis
4. Arthritis Assoc with IBD

Question 3

Seronegative Spondyloarthritis - High Yield

Answer 3

AKA Rhuematoid Spondyltis/Marie-Strump
Chronic Synovitis --> Destroys Art. Cart. --> Bony Ankylosis
MC Joints = SI, Spine
Men 
Present with CHRONIC Low Back Pain
Uveitis
Aortitis
Amyloidosis
HLA-B27

Question 4

Reiter Syndrome - Triad

Answer 4

1. Arthritis
2. Non-gonococcal Urethritis or Cervicitis
3. Conjunctivitis
   Can’t Pee, Can’t See, Can’t Climba Tree

Question 5

Reiter Syndrome - High Yield

Answer 5

Men
HLA-B27
Autoimmune Reaction initiated by prior infx:
- Shigella
- Salmonella
- Yersinia
- Campylobacter
- Chlamydia

Question 6

Reiter Syndrome - Clinical Presentation

Answer 6

Present with:
- Joint Stiffness
- Low back Pain
Assymetric Pattern
Synovitis of digital tendon sheath (sausage)
Chronic Dz - looks just like Ankylosing Sp.
Extraarticular Manifestations:
- conjunctivits
- poor cardiac conduction
- aortic regurgitation

Question 7

Enteritis-Associated Arthritis - Etiology

Answer 7

Arthritis caused by GI infection by Yersinia, Salmonella, Shigella, Campylobacter

Involves knees and ankles

Lasts for a year then disappear

Question 8

Psoriatic Arthritis

Answer 8

Chronic Inflammatory Disease
Associated with Psoriasis
HLA-B27 and HLA-CW6
10% of psoriasis pts will get it
DIP hands and feet - sausage finger
Extra-articular manifestations are uncommon