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MSK > spiondyloarthropathy and inflammatory mimic conditions > Flashcards

spiondyloarthropathy and inflammatory mimic conditions Flashcards

1
Q

What is spondyloarthritis relation with the antibodies anti-CCP and rheumatoid factor

A

It is negative for the rheumatoid arthritis antibodies

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2
Q

Is spondyloarthritis asymmetric or symmetrical

A

Asymmetric

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3
Q

What is enthesitis and what is it seen in

A

Inflammation where ligaments and tendons attach to bone - seen in spondyloarthritis

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4
Q

What are the extra-articular features of spondyloarthritis

A

Uveitis and inflammatory bowel disease

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5
Q

What is psoriatic arthritis caused by

A

psoriasis

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6
Q

What is reactive arthritis caused by

A

infection - typically GI or genito-urinary

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7
Q

In spondyloarthritis what is commonly seen in all of them

A

Sacroiliitis

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8
Q

What is ankylosing spondylitis

A

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

specifically - increased number of osteoblasts which causes vertebrae to fuse in the spine

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9
Q

When does ankylosing spondylitis present

A

2nd to 3rd decade

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10
Q

Which gender is ankylosing spondylitis more common in

A

Males

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11
Q

How is spine mobility measured for spinal flexion and describe how it is done

A

Schober’s test - patient stands straight - mark a line from the two posterior iliac spines - place another mark 10cm above that - ask patient to bend forward as far as they can and then report the increase in cm - then take the best of two attempts

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12
Q

How is spinal mobility checked for lateral spinal flexion

A

Put heels and back and rest against wall - place mark on thigh and bend sidewards - then place another mark on the thigh and record the difference- the best of two tries on each side is done and then the mean is calculated between both times

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13
Q

What are the clinical features of spondyloarthritis

A

Inflammatory back pain
Limitations of movement in the lumbar spine
Limitation of chest expansion
Bilateral sacroiliitis on X-rays

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14
Q

Describe inflammatory back pain

A

Severe early morning stiffness - relieved by activity - night pain can be an issue - buttock pain can also be a symptom

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15
Q

What is the requirements to be diagnosed with axial spondyloarthritis (ankylosing spondyloarthritis)

A

Must have More than 3 months back pain with onset earlier than 45 years old with either:
HLA-B27 positive and more than or equal to 2 other spondyloarthritis features
OR
sacroiliitis on imaging and one or more spondyloarthritis feature

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16
Q

What are the spondyloarthritis features

A

Inflammatory back pain
arthritis
enthesitis
uveitis
dactylitis - inflammation of the digits
Chrons/UC
Psoriasis
Positive response to NSAIDS
family history positive
HLA-B27
Elevated CRP - inflammation marker

17
Q

How is axial spondyloarthritis managed

A

Physiotherapy
NSAIDs - although have long term complications
Short term steroids
conventional synthetic DMARDs - sulfasalazine and methotrexate
Biologic DMARDs - first line - anti-TNF
Surgery - joint replacement and spinal surgery

18
Q

Is psoriatic arthritis symmetrical

A

Yes like rheumatic arthritis

19
Q

What is the most common presentation of psoritatic arthritis

A

Asymmetric oligoarticular arthritis - less than 4 joints affected

20
Q

What is the treatment for psoriatic arthritis

A

First line - methotrexate
Second line - sulfasalazine
Third line - Biologic DMARDs - specifically - Anti-TNF - end in mab

21
Q

What is cyclosporine and anti-inflammatory drugs not often combined

A

They combine to impact renal function

22
Q

What infections commonly cause reactive arthritis

A

salmonella, shigella and campylobacter..

23
Q

How many days after infection does reactive arthritis occur

A

10-14 days

24
Q

How many joints does reactive arthritis affect

A

monoarthritis - one
or
oligoarthritis - less than 4

25
Q

What is reiter’s syndrome

A

Arthritis, urethritis and conjunctivitis

26
Q

What infection causes recurrent attacks in reactive arthritis

A

chlamydia

27
Q

What are signs that the reactive arthritis will be long term

A

Hip/Heel pain
High ESR - inflammation marker
family history positive and positive HLA-B27

28
Q

How is reactive arthritis treated acutely

A

NSAIDS
Joint injections

29
Q

How is chronic reactive arthritis treated

A

NSAIDs and the usual conventional DMARDs - methotrexate and sulfasalazine

30
Q

What is the treatment for enteropathic arthritis

A

NSAIDs difficult to use due to gut issues
conventional DMARDs - methotrexate and sulfasalazine
Biologics - Anti-TNF - end in mab

31
Q
A

MSK (36 decks)

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