Other Inflammatory Arthritis Flashcards Preview

Rheumatology > Other Inflammatory Arthritis > Flashcards

Flashcards in Other Inflammatory Arthritis Deck (41):
1

What do the spondyloarthritides affect generally?

The axial skeleton

2

What do the spondyloarthritides share?

Clinical features

3

Are the spondyloarthritides positive or negative for RhF?

Negative

4

What genetic association do spondyloarthritides have?

HLA B27

5

What is HLA B27?

A gene associated with tiggering inflammatory responses

6

What does axial arthritis mean?

Arthritis of the spine and sacroiliac joints

7

What is dactylitis?

Inflammatoin of an entire digit due to soft tissue oedema, aka sausage digit

8

What extra-articuar manifestations can occur?

Iritis
Psoriaform rash in psoaritic arthritis
Oral ulcers
IBD
Aortic valve incompetent

9

What is ankylosing spondylitis?

Arthritis characterised by chronic inflammation of the joints of the spine and sacroiliac joints

10

Who is commonly affected in ankylosing spondylitis?

M>F between the ages of 17 and 35

11

Over what time period do symptoms develop?

Over several months or years

12

Describe the pain often experienced in AS.

Back pain and stiffness, worst in the mornings and at night, gets better with exercise but no better with rest, and may present in area around the buttocks

13

What is progressively lost in AS?

Spinal movement in all directions

14

What can AS progress to in some cases?

Kyphosis, neck hyperextension, and spinocranial ankylosis

15

What is enthesitis?

A feature of AS - inflammation of the site of insertion of a tendon or ligament inot bone.

16

Where does enthesitis occur?

Usually in the plantar fascia, Achilles tendon, or costal cartilage

17

What % of AS is associated with osteoporosis?

60%

18

How is AS diagnosed?

Climically, with support from imaging

19

What can be seen in an MRI of AS?

Bone marrow oedema
Erosions
Sclerosis
Ankylosis

20

What can be seen in an x-ray of AS?

SI joint space narrowing or widening
Sclerosis
Erosions
Ankylosis/fusion
Vertebral syndesmophytes

21

Where do vertebral syndesmophytes initially appear?

T11-L1

22

What is the bamboo spine?

The xray appearance of calcified ligaments on top of vertebral ankylosis

23

What is the first line treatement for AS?

Exercise ideally with a specialist physiotherapist

24

What can relieve AS symptoms?

NSAIDs

25

What treatment is indicated in severe AS?

TNF alpha blockers

26

Name some TNF alpha blockers

Etanercept
Adalimumab

27

What is indicated if there is risk of osteoporotic fractures?

Bisphosphonates

28

What are poor prognostic features for AS?

-ESR >30
-Onset earlier than age 16
-Early hip involvement
-NSAIDs ineffective

29

What is enteropathic arthritis?

Acute or subacute arthritis in association with, or as a reaction to, an enteric (usually colonic) inflammatory condition.

30

Which enteric conditions are associated with enteropathic arthritis?

IBD
GI bypass
Coeliac disease
Whipple's disease

31

What is the best treatment for enteropathic arthritis?

Treatment of the underlying cause

32

What treatments can and can't be used?

DMARDs can in resistant cases
NSAIDs should not be used

33

How many people with psoriasis get psoriatic arthritis?

10-40%

34

Can psoriatoc arthritis present before skin changes?

Yes

35

Which joints are affected in PA?

Symmetrical polyarthritis like in RA
Spinal involvemnt like in AS.
DIP joints

36

What can be seen on xrays of psoriatic arthritis?

Erosive changes
"Pencil in a cup" in severe cases

37

What % of PA cases have nail changes?

80%

38

How is PA managed?

NSAIDs, sulfasalazine, and methotrexate.

39

What is reactive arthritis?

A condition where arthritis and other manifestations occur as an autoimmune response to infection elsewhere in the body

40

What is reactive arthritis typically due to?

GI or GU infections

41

Does the initial infection have to be active when reactive arthritis presents?

No