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10 Cards in this Set

  • Front
  • Back
-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
how diff inflam back pain from mechanical
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
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
-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"(
ankylosing spondylitis
-pulm: restrictive lung dz
-heart: heart block, pericarditis
reiter's syndrome
triad: arthritis, conjunctivitis, urethritis

Dx criteria:
-seronegative (Rh(-)) asymmetric arthropahty (HEEL PAIN @ ACHILLES TENDON) plus:
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)
how get reiters
HLA B27 ppl, then they get:
a. post dysenteric (shigella, e coli, salmonella, yersinia)

b. post venereal (non-gonococclal urethritis/cervicitis)
psoriatic arthritis
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

1. nail changes
2. involves DIP's (OA and psoriatic arthritis are the only arthrites that affet DIPs)
2 types:
1. Peripheral arthritis: not assoc w/HLA B27
2. spondylitis: HLA B27

-looks like ankylosing spondylitis with symmetrically axeneidng spondylitis
progression pattern of the spondyloarthropahties
Ankylosing Spond/IBD: ascending
symmetrical sacroilitis
symmetrical syndesmophytes

Reiters, Psoriatic arthritis:
progression: skips thoracic
asymm sacroilitis
asymm syndesmophytes