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17 Cards in this Set
- Front
- Back
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What are the 4 types of spondyloarthropathies in adults?
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• ankylosing spondylitis
• reactive arthritis (Reiter's disease) • enteropathic arthritis (inflammatory bowel disease) • psoriatic arthritis |
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What are the cardinal features of the spondyloarthropathies?
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• 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) |
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Ankylosing spondylitis is more common in what part of the population?
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adolescent boys and young men
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Which major histocompatibility antigen is strongly associated with spondyloarthropathies?
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HLA-B27
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What are some bacterial species that can induce a reactive arthritis?
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• GU infections (ex. Chlamydia trachomatis)
• GI infections (ex. Shigella, Salmonella, Campylobacter, Yersinia) • Klebsiella pneuomoniae |
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What are the hallmarks of spondyloarthropathies that are not seen in any other rheumatic disease?
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• sacroiliitis
• spondylitis |
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How can sacroiliitis clinically present?
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• 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) |
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What are the effects of the bone fusion that occurs in sacroiliac joints and spine?
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• increased risk of vertebral fractures
• kyphosis • pain and stiffness • reduce range of motion • restrictive lung physiology (due to involvement of spine and costovertebral joints |
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Describe characteristics of the peripheral arthritis that develop in spondyloarthropathies
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• episodic, asymmetric, oligoarticular process
• involves the lower extremities • can progress to chronic and disabling arthritis |
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What is dactylitis?
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• aka sausage digits
• the appearnace of fusiform swelling of an entire finger or toe • a unique feature of spondyloarthropathies |
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What are other organ systems that can be affected by spondyloarthropathies?
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• aortitis
• pulmonary fibrosis • spinal cord compression • amyloidosis |
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What joints are frequently affected by reactive arthritis?
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large weight-bearing joints (ex. knee & ankle)
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What is Keratoderma blennorrhagicum?
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• a distinct papulosquamous rash usually found on the palms and soles
• seen in Reiter's syndrome |
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What is Circinate balanitis?
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• a rash that may appear on the penile glands or shaft
• seen in Reiter's syndrome |
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What are 5 indentifiable clinical patterns of psoriatic arthritis?
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• DIP joint involvement w/ nail pitting
• asymmetrical oligoarthropathy • arthritis mutilans (a severe, destructive arthritis) • symmetrical polyarthritis • spondyloarthropathy |
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What is the earliest radiographic sign of spondyloarthropathies?
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• sacroiliitis
• results in sclerosis and erosions of the SI joints w/ eventual bony fusion |
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What are some medical treatment options for spondyloarthropathies?
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• NSAIDS (most important medical therapy)
• Intra-articular glucocorticoid injections (provide temporary relief) • Sulfasalazine & Methotrexate (used for peripheral arthritis) • anti-TNF therapy |
