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Flashcards in Seronegative arthropathies Deck (26):
1

What are seronegative arthropathies?

A family of inflammatory arthritides characterized by involvement of both the spine and joints

2

What are some of the features of seronegative arthropathies?

Sacroiliac and spinal involvement
Enthesitis
Inflammatory arthritis
Dactylitis (sausage digits)

3

What is enthesitis?

Inflammation of the enthuses, the sites where ligament or tendon insert into the bone

4

What are some extra-articular features of seronegative arthropathies?

Ocular involvement e.g. conjunctivitis
Mucocutaneous lesions
Aortic incompetence
Heart block

5

Which gene are seronegative arthropathies associated with?

HLA B27

6

When is the typical period of onset for ankylosing spondylitis?

Late teens/early adulthood

7

What are the symptoms of ankylosing spondylitis?

Back pain and stiffness that improves with exercise and isn't relieved by rest
Pain and swelling elsewhere e.g. hips, knees and ribs
Fatigue

8

What are some of the treatments for ankylosing spondylitis?

Home exercises
Physiotherapy
Occupational therapy
NSAID
Corticosteroids
Anti TNF treatment – Infliximab, adalimumab

9

Which joints are usually affected in ankylosing spondylitis?

Sacroiliac joints

10

What is Schober's test?

A test used to assess the patient's ability to flex their back
The distance between two fingers placed on the lower back is measured while standing
The patient is then asked to touch their toes, and the increase in distance between fingers is measured

11

What is psoriatic arthritis?

Arthritis associated with psoriasis
Only in a small number of cases does the arthritis precede the psoriasis

12

What is onycholysis?

The separating of the nail from the nail bed

13

What are the features of psoriatic arthritis?

Sacroiliitis
Nail involvement - pitting, onycholysis
Achilles tendinitis
Plantar fasciitis
Dactylitis
Skin disease
Eye involvement

14

In which seronegative arthropathy can "whiskering" and/or a "pencil in cup" deformity be seen on Xray?

Psoriatic arthritis

15

What is reactive arthritis?

An autoimmune disease which causes arthritis to develop in response to an infection from elsewhere (cross-reactivity)

16

What are the most common causative organisms for reactive arthritis?

Chlamydia
Salmonella
Shigella
Yersinia

17

What are some of the clinical features of reactive arthritis?

General Symptoms (fever, fatigue, malaise)
Asymmetrical monoarthritis or oligoarthritis
Enthesitis
Mucocutaneous lesions

18

What are some examples of mucocutaneous lesions?

Keratodema blenorrhagica (vesicular lesions on palms and soles)
Circinate balanitis (dermatitis on penis)
Painless oral ulcers
Hyperkeratotic nails

19

What is the triad of Reiter's syndrome?

Arthritis
Urethritis
Conjuntivitis

20

What extra-articular features are involved in ankylosing spondylitis?

Aortic regurgitation
Apical fibrosis
Anterior uveitis
AV node block
Achilles tendonitis
Axial arthritis
Amyloidosis/IgA nephropathy

21

Which gender is more commonly affected in ankylosing spondylitis?

Male

22

Which gender is more commonly affected in psoriatic arthritis?

No gender preference

23

What is the treatment for psoriatic arthritis?

NSAIDs
Corticosteroids/joint injections
DMARDs
Anti TNF – etanercept

24

What blood tests would indicate psoriatic arthritis?

Negative rheumatoid factor
Raised inflammatory parameters

25

When do symptoms of reactive arthritis occur?

4-5 weeks following infection

26

What is the treatment for reactive arthritis?

NSAIDs
Corticosteroids (once sepsis ruled out): intra-articular, oral or eye drops
Antibiotics
DMARDs (sulphasalazine) if resistant/chronic