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16 Cards in this Set
- Front
- Back
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Chronic systemic seronegative spondyloarthropathy with psoriasis
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Psoriatic Arthritis
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Who gets Psoriatic Arthritis
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35 – 50 yo
Men have more spinal and DIP involvement, women more symmetric HLA B27 in 10–50% (higher if spondylitis) |
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Whats the relation between arthritis and psoriasis?
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Arthritis occurs in 5–8% of patients with psoriasis
Arthritis occurs after psoriasis in 75%, synchronous in 15%, before in 10 |
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Psoriatic Arthritis presentation
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asymmetric, IP joints of hands/feet
Sacroiliitis and spondylitis with paravertebral ossification Bony erosions with adjacent proliferation, bony ankylosis Dactylitis: destruction of phalangeal tufts, telescoping fingers Extraskeletal: Anterior uveitis, cardiopulmonary Dx, mucosal lesions |
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Psoriatic Arthritis tx
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NSAIDs, MTX, sulfasalazine, steroids, TNF inhibitors
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Sterile joint infection that develops after a distant infection
Triad: urethritis, conjunctivitis, arthritis |
Reactive Arthritis “Reiter’s Syndrome
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who gets Reactive Arthritis “Reiter’s Syndrome
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Young adults
HLA–B27 association (seen in 70% of Caucasians) Typically after a diarrheal or chlmaydial infection |
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Reactive Arthritis “Reiter’s Syndrome manifestation in
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Arthritis, asymmetric, <5 joints, knees, ankles, feet
Skin: psoriasis, nail dystrophies Enthesopathies (heel pain), tendonitis (Achilles) Keratoderma blenorrhagicum, circinate balanitis Oral ulcers Conjunctivitis, uveitis Arthritis, asymmetric, <5 joints, knees, ankles, feet Skin: psoriasis, nail dystrophies Enthesopathies (heel pain), tendonitis (Achilles) Keratoderma blenorrhagicum, circinate balanitis Oral ulcers Conjunctivitis, uveitis *Keratoderma blenorrhagicum are lessions on the bottom of their feet and a ring rash around gland of the penis (circinate) are common in this disease. If chlamydia present treat the clamydia |
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Reactive Arthritis “Reiter’s Syndrome tx
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Rest acutely, ice, exercise later, Ab for Chlamydia
NSAIDs, intraarticular steroids ± systemic steroids |
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Pyoderma gangrenosum
Aphthous ulcers Inflammatory eye disease Nodosum (Erythema) |
Enteropathic Arthritis Arthritis associated with bowel infection or inflammation
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Enteropathic Arthritis tx
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NSAIDS
Steroid injections Sulfasalazine Immunosuppressants Bowel resection |
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Cytoplasmic ANCA (cANCA): Anti–Proteinase 3 (PR3)
associated with |
Granulomatosis with polyangiitis (90%)
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Perinuclear ANCA (pANCA): Anti–Myeloperoxidase (MPO)
associated with |
Churg Strauss
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Diagnostic Criteria for Giant Cell Arteritis (Large artery vasculitis) “BEATL”
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Biopsy with necrotizing arteritis and mononuclear or multinuclear giant cell infiltration
ESR over 50 Age over 50 Tender or decreased temporal pulse Localized headache of new onset Any 3 of 5 = sensitivity of 94%, specificity of 91% |
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Giant Cell Arteritis often present with complains like
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Jaw claudication means people get tired of chewing like gum. Polymyalgia rheumatica they feel weakness in the shoulders and proximal joints but it is pain.
Very responsive to steroids |
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Age less than or equal to 40
Claudication of extremities Decreased brachial pulse BP > 10 mm difference between arms Subclavian or aortic bruit Arteriography with narrowing/occlusion of aorta, its branches or large arteries of extremities |
Takayasu’s Arteritis (large artery vasculitis)
Any 3 of 5 = sensitivity of 90%, specificity of 98 |
