spondyloarthritis

Question 1

spondyloarthritis differentiate

Answer 1

Axial
peripheral
extra articular

Question 2

eg spondyloarthritis

Answer 2

psoaritic arthritis
ankylosing spond
associated with IBD
reactive arthritis

Question 3

Features of spondyloarthritis

Answer 3

inflammatory back pain
oligoarthritic pain
sacroiliitis
dactylitis
uveitis
reactive
associated with IBD
psoarisis
HLA b27

Question 4

Inflammatory back pain charac

Answer 4

Onset before 40
insidious onset
Improves with exer
not better with rest

Question 5

Pathogenesis SPA

Answer 5

Chronic subclinical gut inflammation—-which leads to increased IL2# —-which activates th17——-which produce IL17, tnf alpha and Il 22

Question 6

Ankylosisng spondylitis- most common peripheral joint

Answer 6

HIP

Question 7

AS clinical features- extra axial involvement

Answer 7

oligo arthritis

enthesitis- achiles tendons, planta fascitis

Question 8

diagnosis ANkylosing spondylitis

Answer 8

CLinical (need one)
Inflam low back pain 3 months atleast
restriction lumbar forward and lat flexion
restriction chest wall

Radiology
bilateral grade 2 sacroileatis
unilateral grade 3-4

one from radiology and one from clinical

Question 9

BIological treatment Ankylosing spondylitis

Answer 9

TNF inhibitors- Adalumumab, infliximab

IL-17 inhib - Secukinumab

Question 10

Psoaritis arthritis clinical features- distinct patterns

Answer 10

assymetric oligoarthritis
polyarthritis - symmetric
spndyloarthritis
DIP- with nail disease
arthritis mutilans

Question 11

Psoarisis diagnosis

Answer 11

Peripheral arthritis/axial plus
3 points
Present skin psoriasis (2 points)
• Past or Family Hx of psoriasis (1 point)
• Dactylitis (1)
• Nail changes – pitting, onycholysis (1)
• RF negative (1)
• Juxta-articular new bone formation on x-ray (1)

Question 12

ustekinumab mech action

Answer 12

inhibits IL 12 and 23

Question 13

IBD associated spondylo features

Answer 13

acute + oligo arthritis
erosions rare
self limiting