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17 Cards in this Set

  • Front
  • Back
What are the 4 types of spondyloarthropathies in adults?
• ankylosing spondylitis
• reactive arthritis (Reiter's disease)
• enteropathic arthritis (inflammatory bowel disease)
• psoriatic arthritis
What are the cardinal features of the spondyloarthropathies?
• inflammation of the sacroiliac joints (sacroiliitis)
• inflammation of the spine (spondylitis)
• inflammation of tendon insertion sites (enthesitis)
• inflammation of the anterior chamber of the eye (uveitis)
Ankylosing spondylitis is more common in what part of the population?
adolescent boys and young men
Which major histocompatibility antigen is strongly associated with spondyloarthropathies?
What are some bacterial species that can induce a reactive arthritis?
• GU infections (ex. Chlamydia trachomatis)
• GI infections (ex. Shigella, Salmonella, Campylobacter, Yersinia)
• Klebsiella pneuomoniae
What are the hallmarks of spondyloarthropathies that are not seen in any other rheumatic disease?
• sacroiliitis
• spondylitis
How can sacroiliitis clinically present?
• subtle low back or gluteal pain (but can also be severe)
• morning stiffness
• pain after peiods of inactivity
• can mimic sciatica (w/ radiation of pain into gluteal and posterior thigh)
What are the effects of the bone fusion that occurs in sacroiliac joints and spine?
• increased risk of vertebral fractures
• kyphosis
• pain and stiffness
• reduce range of motion
• restrictive lung physiology (due to involvement of spine and costovertebral joints
Describe characteristics of the peripheral arthritis that develop in spondyloarthropathies
• episodic, asymmetric, oligoarticular process
• involves the lower extremities
• can progress to chronic and disabling arthritis
What is dactylitis?
• aka sausage digits
• the appearnace of fusiform swelling of an entire finger or toe
• a unique feature of spondyloarthropathies
What are other organ systems that can be affected by spondyloarthropathies?
• aortitis
• pulmonary fibrosis
• spinal cord compression
• amyloidosis
What joints are frequently affected by reactive arthritis?
large weight-bearing joints (ex. knee & ankle)
What is Keratoderma blennorrhagicum?
• a distinct papulosquamous rash usually found on the palms and soles
• seen in Reiter's syndrome
What is Circinate balanitis?
• a rash that may appear on the penile glands or shaft
• seen in Reiter's syndrome
What are 5 indentifiable clinical patterns of psoriatic arthritis?
• DIP joint involvement w/ nail pitting
• asymmetrical oligoarthropathy
• arthritis mutilans (a severe, destructive arthritis)
• symmetrical polyarthritis
• spondyloarthropathy
What is the earliest radiographic sign of spondyloarthropathies?
• sacroiliitis
• results in sclerosis and erosions of the SI joints w/ eventual bony fusion
What are some medical treatment options for spondyloarthropathies?
• NSAIDS (most important medical therapy)
• Intra-articular glucocorticoid injections (provide temporary relief)
• Sulfasalazine & Methotrexate (used for peripheral arthritis)
• anti-TNF therapy