Seronegative Inflammatory Arthropathies

Question 1

name the 4 diseases that are seronegative in nature

Answer 1

AS
psoratic arthritis
enteropathic arthritis
reactive arthritis

Question 2

name the part of the body that is mainly affected in seronegative inflammatory arthropathies

Answer 2

spine - spondyloarthropathy and an asymmetric oligoarthritis

Question 3

sacroiliitis, uveitis, dactylitis (inflammation of a digit) and enthesopathies are common (especially achilles insertional tendonitis and plantar fasciitis) in seronegative inflammatory arthropathies

true or false?

Answer 3

true

Question 4

those with seronegative inflammatory arthropathies are usually positive in what?

Answer 4

HLA-B27

Question 5

what is often elevated in seronegative inflammatory arthropathies?

Answer 5

CRP and ESR

Question 6

name the chronic inflammatory disease of the spine and sacro‐iliac joints which can lead to eventual fusion of the intervertebral joints and SI joints

Answer 6

ankylosing spondylitis

Question 7

what sex are more affected by AS?

Answer 7

male aged 20-40

Question 8

is AS painful?

Answer 8

yes - also stiff

Question 9

do those with AS have morning stiffness?

Answer 9

yes - improves with exercise

Question 10

in AS, there is development of a ‘_________ ____’ spine

Answer 10

in AS, there is development of a ‘QUESTION MARK’ spine

Question 11

in an AS spine, there is ____ of lumbar ________ and ___________ thoracic ________

Answer 11

in an AS spine, there is LOSS of lumbar LORDOSIS and INCREASED thoracic KYPHOSIS

‘L-L-L’

Question 12

how is lumbar spine flexion measured?

Answer 12

Schobers test

Question 13

name some associated conditions of AS

Answer 13

anterior uveitis
aortitis
pulmonary fibrosis
amyloidosis

Question 14

x-ray findings of AS?

Answer 14

sclerosis and fusion of the sacroiliac joints

bony spurs from vertebral bodies - syndesmophytes

‘bamboo spine’

Question 15

what test can detect earlier features of AS?

Answer 15

MRI - bone marrow oedema and enthesitis of the spinal ligaments

Question 16

AS treatment?

Answer 16

physiotherapy
exercise
NSAIDs
anti-TNF inhibitors

DMARDs have no impact on spine but good for peripheral joint inflammation

surgery for hip and knee arthritis and kyphoplasty to straighten spine

Question 17

what affects 30% of people with psoriasis?

Answer 17

psoriatic arthritis

Question 18

is psoriatic arthritis symmetrical?

Answer 18

no - asymmetrical oligoarthritis but may also affect hands similar to OA

spondylitis, dactylitis and enthesitis commonly occur

Question 19

state the nail changes in psoriasis

Answer 19

pitting and onycholysis (lifting of nail from bed)

Question 20

what joint of the finger is commonly affected in psoriatic arthritis?

Answer 20

DIP

Question 21

name the aggressive and destructive form of the condition seen in 5% of those with psoriatic arthritis

Answer 21

arthritis mutilans

Question 22

psoriatic arthritis treatment?

Answer 22

similar to RA

DMARDs - methotrexate

anti-TNF

joint replacement in larger joints and joint fusion

Question 23

name the nflammatory arthritis involving the peripheral joints and sometimes spine, occurring in patients with inflammatory bowel disease (Crohn’s disease and Ulcerative Colitis)

Answer 23

enteropathic arthritis

Question 24

what joints are affected in enteropathic arthritis?

Answer 24

large joints asymmetrical oligoarthritis

Question 25

10-20% of IBD sufferers experience problems o this part of the skeleton

Answer 25

spine and joint problems

Question 26

name the arthritis that occurs in response to an infection in another part of the body, most commonly genitourinary infections (Chlamydia, Neisseria) or GI infections (Salmonella, Campylobacter)

Answer 26

reactive arthritis

Question 27

what joint is commonly affected in reactive arthritis?

Answer 27

knee

Question 28

name the triad of symptoms in reactive arthritis

Answer 28

urethritis, uveitis or conjunctivits and arthritis

Question 29

urethritis, uveitis or conjunctivits and arthritis is the triad of what syndrome?

Answer 29

reiter’s syndrome

Question 30

reactive arthritis treatment?

Answer 30

treat infection
IA/IM steroid injections
occasionally DMARDs