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10 Cards in this Set
- Front
- Back
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spondyloarthropathies
-ex's? -char? |
EX's
-Ankylosing spondylitis/IBD -Reiter's, Psoriatic Spondylitis 1. sacroitilis 2. pathology centered at enthesis (where ligaments/tendons attach to bone) 3. enthesopathy (inflam and cell infiltration, and eventual calcification at site of inflamm) 4. all may involve eye, aortic valve, lung 5. HLA B27 |
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how diff inflam back pain from mechanical
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inflamm back pain
1. early age on onset <40 yrs 2. insidious onset/duration >3 mo before consult MD 3. AM stiffness 5. pain improved by exercise, worsened by rest |
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sacroilitis
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lower 2/3 synovially lined, upper 1/3 fibrous
dz stats in lower 2/3's, on iliac side where cartilage is thinner than sacral side |
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spondylitis
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-caused by enthesopathy (inflamm and cellular infiltration-->calcification)
inflam at enthesis ==>squaring of vertebrl bodies ==>calcification and new bone formation that eventually spans the space b/w vertebrae ("syndesmophytes"( |
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ankylosing spondylitis
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-iritis
-pulm: restrictive lung dz -heart: heart block, pericarditis |
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reiter's syndrome
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triad: arthritis, conjunctivitis, urethritis
Dx criteria: -seronegative (Rh(-)) asymmetric arthropahty (HEEL PAIN @ ACHILLES TENDON) plus: a.urethritis/cervicitis b.inflamm eye dz c. mucocutaneous dz: oral ulceration, keratoderma blennorrhagicum (on soles and feet) *note: spondylitis is asymm with skip aras (skip thoracic spine) |
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how get reiters
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HLA B27 ppl, then they get:
a. post dysenteric (shigella, e coli, salmonella, yersinia) b. post venereal (non-gonococclal urethritis/cervicitis) |
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psoriatic arthritis
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2 types:
1. Axial skeleton: HLA B27, looks like Reiters 2. Peripheral joints: *erosive arthritis, assym on lower ext or distal WITH ACTUAL LYSIS OF BONE; *hallmark-prolierative new bone formation also: 1. nail changes 2. involves DIP's (OA and psoriatic arthritis are the only arthrites that affet DIPs) |
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IBD
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2 types:
1. Peripheral arthritis: not assoc w/HLA B27 2. spondylitis: HLA B27 -looks like ankylosing spondylitis with symmetrically axeneidng spondylitis |
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progression pattern of the spondyloarthropahties
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Ankylosing Spond/IBD: ascending
symmetrical sacroilitis symmetrical syndesmophytes Reiters, Psoriatic arthritis: progression: skips thoracic asymm sacroilitis asymm syndesmophytes |
