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MSK > Lecture 19 Seronegative Arthritis (Spondyloarthritis) > Flashcards

Lecture 19 Seronegative Arthritis (Spondyloarthritis) Flashcards

1
Q

What is seronegative arthritis (Spondyloarthritis)

A

Arthritis with negative rheumatoid factor

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2
Q

Is seronegative arthritis (Spondyloarthritis) asymmetric or symmetric

A

Asymmetric

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3
Q

What are extra-articular features of seronegative arthritis (Spondyloarthritis)

A

Uveltis, IBD

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4
Q

What are the different clinical presentation of seronegative arthritis (Spondyloarthritis)

A 
•	Ankylosing Spondylitis
•	Psoriatic arthritis
•	Bowel related arthritis (Crohn’s, UC)
•	Reactive arthritis
Juvenile ankylosing spondylitis
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5
Q

What is ankylosing Spondylitis

A

Chronic inflammatory rheumatic disorder with a predilection for axial skeleton and entheses

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6
Q

Is ankylosing Spondylitis more common in females or males

A

Males

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7
Q

How do you assess spinal mobility in ankylosing Spondylitis

A
  1. Modified Schober
  2. Lateral Spinal Flexion
  3. Occiput to wall and Tragus to wall
  4. Cervical Rotation
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8
Q

Clinical features of ankylosing spondylitis

A
  • Inflammatory back pain
  • Limitation of movements in antero-posterior as well as lateral planes at lumbar spine
  • Limitation of chest expansion
  • Bilateral sacroiliitis on X-rays
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9
Q

What is the ASAS Classification Criteria for Axial Spondylitis

A

Patients with >3months back pain
Age onset <45 years
Sacroiliitis on imaging plus >1 SpA feature or HLA-B27 plus > the SpA features

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10
Q

Name SpA features

A 
Inflammatory back pain
Arthritis
Enthesitis (heel)
Uveitis
Dactylitis
Psoriasis
Chron's/Colitis
Good response to NSAIDs
Family history for SpA
HLA-B27
Elevated CRP
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11
Q

What are the management of ankylosing spondylitis

A
  • Physiotherapy
  • NSAIDs
  • DMARDs- Sulfasalazine
  • Anti-TNF
  • Anti-IL-17
  • Treatment of osteoporosis
  • Surgery- joint replacements & spinal surgery
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12
Q

Name joints commonly affected by psoriatic arthritis

A 
Neck
Shoulder
Elbows
Base of spine
Wrists
All joints of knuckles, fingers and thumbs
Knees
Ankles
All joints of toes
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13
Q

Name treatments of Psoriatic Arthritis

A 
Sulfasalazine
Methotrexate 
Leflunomide
Cyclosporine
Anti-NF therapy
Anti-IL-17 and IL-23
Steroids
Physiotherapy and OT
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14
Q

What is reactive arthritis

A

Sterile synovitis after distant infection

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15
Q

What organisms are linked to reactive arthritis

A

Salmonella, Shigella, Yersinia, Campylobacter, Chlamydia trachomatis or pneumoniae, Borrelia, Neisseria and streptococci

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16
Q

What is Reiter’s Syndrome

A

Arthritis, urethritis and conjunctivitis

17
Q

Name prognostic signs of chronicity in Reactive Arthritis

A

o Hip/heel pain
o High ESR
o Family history and HLA-B27 +ve

18
Q

What are the treatments for acute reactive arthritis

A

NSAID
Joint injection
Antibiotics in chlamydia infection

19
Q

What are the treatments for chronic reactive arthritis

A 
NSAID
DMARD (methotrexate, sulphasalazine)
Steroids
Anti-TNF
Bowel resection may alleviate peripheral disease

MSK (33 decks)

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