Spondyloarthropathies (mind-maps) Flashcards Preview

Medicine Phase 2a MSK and Rheumatology > Spondyloarthropathies (mind-maps) > Flashcards

Flashcards in Spondyloarthropathies (mind-maps) Deck (36)
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1
Q

Examples

A
PEAR:
Psoriatic arthritis
Enteropathic arthropathies
Ankylosing spondylitis
Reactive arthritis
2
Q

What is reactive arthritis?

A

This is an asymmetrical arthritis that occurs post gastrointestinal or urogenital infection

3
Q

Causes of reactive arthritis

A

The exact cause and pathophysiology of this condition is not known
However, it often occurs after an infection, typically, a sexually transmitted infection or an infection of the gastrointestinal tract

4
Q

Signs and symptoms of reactive arthritis

A

Urethritis
Arthritis: pain and stiffness
Uveitis/conjunctivitis

5
Q

Investigations of reactive arthritis

A

Bloods

Radiology - X-ray of infected joint (assesses severity)

6
Q

Investigations of reactive arthritis - what is looked for with bloods

A

Seronegative for rheumatoid factor
Blood cultures
Look for infectious cause

7
Q

Conservative treatment of reactive arthritis

A

Patient education

Refer to physiotherapy

8
Q

Medical treatment of reactive arthritis

A

Analgesia
Non-steroidal anti-inflammatory drugs (NSAIDs)
Disease modifying anti-rheumatic drugs (DMARDs) e.g. sulphasalzine

9
Q

Complications of reactive arthritis

A

Arrhythmia
Uveitis
Aortic insufficiency

10
Q

What is psoriatic arthritis

A

Inflammatory arthritis that is associated with skin condition psoriasis. The signs and symptoms also depend on how and where the joints are affected.

11
Q

**5 subtypes of psoriatic arthtritis

A
Asymmetrical oligoarthritis (distal and proximal inter-phalangeal joints)
Symmetrical rheumatoid-like arthropathy
Ankylosing spondylitis variant
Polyarteritis with skin and naik changes
12
Q

Causes of psoriatic arthritis

A

Exact cause is unknown
Thought to be due to an inflammatory process coupled with genetic involvement of the HLA B27 gene
Family Hx of psoriasis

13
Q

What is greatest risk factor of psoriatic arthritis

A

Family Hx of psoriasis

14
Q

Signs and symptoms of psoriatic arthritis

A

Psoriasis
Joint pain and stiffness
Swelling of affected joints
Nail changes

15
Q

Describe the nail changes in psoriatic arthritid

A

Yellowing of the nail
Onycholysis (painless detachment of the nail from the nail bed)
Pitting
Subungal hyperkeratosis (buildup of soft yellow keratin in the space created by the onycholysis)

16
Q

What is psoriasis

A

Well-demarcated salmon-pink plaques with evidence of scalling
These plaques are usually present on the extensor surfaces (chronic plaque psoriasis), but sometimes smaller plaques may occur in a raindrop pattern over the torso
This is called guttate psoriasis and is often preceded by an upper respiratory tract infection/sore throat caused by Streptococcus

17
Q

Investigations of psoriatic arthritis

A

Psoriasis is a clinical diagnosis
Bloods - seronegative for Rheumatoid factor
Radiology - X- ray pf affected joints to assess severity

18
Q

What hand deformity is seen (also on X-ray) of psoriatic arthritis

A

‘Pencil-in-cup’ deformity

19
Q

Conservative treatment of psoriatic arthritis

A

Patient education
Refer to physiotherapy
Explain to patients that psoriasis does not have a cure and control of the disease is more realistic

20
Q

Medical treatment of psoriatic arthritis

A

Analgesia (nonsteroidal anti-inflammatory drugs - NSAIDs)
Disease modifying antirheumatic drugs (DMARDs) e.g. methotrexate (FIRST LINE)
Manage psoriasis

21
Q

Surgical treatment of psoriatic arthritis

A

Rarely joint placement

22
Q

Complications of psoriatic arthritis

A

Neurological manifestations if atlanto-axial joint involvement
Joint destruction

23
Q

What are enteropathic arthropathies

A

An arthritis that develops in association with inflammatory bowel disease (IBD)
It is indistinguishable from reactive arthritis

24
Q

Cause of enteropathic arthritis

A

Exact cause is unknown, however it is thought to be associated with HLA B27

25
Q

Signs and symptoms of enteropathic arthritis

A

Those of IBD
Spondylitis
Sacroiliitis
Peripheral arthritis - usually of large joints

26
Q

Investigations of enteropathic arthritis

A

Those for IBD

Radiology - X-ray of affected joint; assess severity

27
Q

Treatment of enteropathic arthritis

A

Analgesia (NSAIDs)

Treatment of IBD

28
Q

Complications of enteropathic arthritis

A

Severely decreased mobility with axial involvement

29
Q

What is ankylosing spondylitis

A

Chronic inflammatory disease of the spine and sacroiliac joints.
There is predominance in young males and the condition is associated with HLA B27 (positive in 95%)

30
Q

Causes of ankylosing spondylitis

A

Exact cause and pathophysiology of this condition are not known. However, it is thought to be associated with HLA B27

31
Q

Signs and symptoms of ankylosing spondylitis

A

Question mark posture
Bamboo spine - due to calcification of ligaments
Pain and stiffness - symptoms improve with exercise

32
Q

Investigations of ankylosing spondylitis

A

Bloods - seronegative for rheumatoid factor

Radiology - CXR and MRI scan assess changes in the spine

33
Q

Conservative treatment of ankylosing spondylitis

A

Patient education

Refer to physiotherapy

34
Q

Medical treatment of ankylosing spondylitis

A

Analgesia (NSAIDs) and DMARDs e.g. Sulphasalzine (FIRST LINE)

35
Q

Surgical treatment of ankylosing spondylitis

A

Corrective spinal surgery

36
Q

Complications of ankylosing spondylitis

A

Osteoporosis
Spinal fractures
Increased risk of cardiovascular disease e.g. stroke and myocardial infarction