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Flashcards in Seronegative arthritis Deck (21):
1

Shared clinical features of spondyloarthritides

Seronegative
HLAB27
Pathology in spine and sacroiliac joints
Enthesitis
Dactylitis
Extra articular manifestations

2

Definition of seronegative

Plasma negative for RF

3

Types of seronegative arthritis

Spondyloarthritis
Psoriatic arthritis
Reactive arthritis
Enteropathic arthritis

4

Difference between ankylosing spondylitis and spondyloarthritis

Called spondyloarthritis until radiological evidence of sacroiliac and spinal joint damage, then called ankylosing spondylitis

5

Describe ankylosing spondylitis

Chronic inflammation of spine and sacroiliac joints

6

Symptoms of ankylosing spondylitis

Gradual onset lower back pain radiating to buttocks and hips
Morning stiffness relieved by exercise
Worse at night
Progressive reduction in ROM in all directions

7

Associated symptoms of ankylosing spondylitis

Anterior uveitis
Aortic regurgitation
Achilles tendinitis
Apical lung fibrosis
AV block
Costochondritis
Osteoporosis

8

How to test sacroiliac joints

FABER:
Hip flexion, abduction and external rotation

Positive if induces sciatic nerve irritation

9

Criteria to assess ankylosing spondylitis severity

BASDAI
BASFI

9

X-ray features of ankylosing spondylitis

Sacroiliac joint space narrowing or widening
Sclerosis
Erosions
Fusion
Dagger spine - fusion of spinous processes
Bamboo spine - fusion of vertebral bodies (calcification of ligaments)

10

Stepwise treatment for ankylosing spondylitis

First line: physio for spinal mobility
Second line: NSAID for 2 weeks, if not successful then try a different NSAID for 2 more weeks
Third line: TNF antagonist

10

When should you go straight to third line treatment in ankylosing spondylitis

BASDAI at least 4

11

Nail changes in psoriatic arthritis

Pitting
Horizontal ridges
Yellow discolouration
Nails curve upwards

13

Management of psoriatic arthritis

NSAIDs
Sulfasalazine
Methotrexate
Anti-TNF

14

X ray appearance of psoriatic arthritis

Pencil in cup deformity

15

Describe reactive arthritis

Autoimmune response to infection (typically GI or GU)

16

Associated symptoms in reactive arthritis

Iritis
Balanitis
Mouth ulcers
Enthesitis
Reiters syndrome

18

Describe reiters syndrome

Urethritis - usually gonorrhoea
Uveitis or conjunctivitis
Reactive arthritis

19

Management of reactive arthritis

Stool culture if diarrhoea
Sexual health review
Treat underlying infection if still present
NSAIDs
If symptoms >6 months try sulfasalazine or methotrexate

20

Associations of enteric arthropathy

IBD
Gastric bypass
Coeliac disease
Whipples disease

21

Management of enteric arthropathy

Treat underlying bowel symptoms (caution with NSAIDs)