Psoriatic arthritis affects 30% of patients with psoriasis In 60% psoriasis precedes the arthritis In 15% the sx occur simultaneously In 25% the arthritis appears first Typical presentations Often intermittent Sx ‘A 45 y/o female presents to her GP with [slideserve.com]

[…] in 95% of AS patients but only 6% of normal population A seronegative arthritis which usually presents as an inflammatory, peripheral mono- or oligo- arthritis (wrists or knees) Rarely presents with polyarthritis or spinal disease A rare destructive [brainscape.com]

Probable AS is present if 3 clinical criteria are present or if one of the radiologic criteria is present without any signs or symptoms satisfying the clinical criteria. From van der Linden S, et al. [hss.edu]

[…] alternating between right and left gluteal areas - past or present enthesopathy - past or present spontaneous pain or tenderness at site of insertion of Achilles tendon or plantar fascia sacroilitis - bilateral grade 2-4 or unilateral grade 3-4 using [enotes.tripod.com]

• Anemia

  Aplastic Anemia.- Fanconi's Anemia.- Pernicious Anemia.- Idiopathic Autoimmune Hemolytic Anemia.- Congenital Neutropenia.- Chronic Familial Neutropenia.- Autoimmune Thrombocytopenic Purpura.- Idiopathic Thrombocytopenic Purpura.- Paroxysmal Noctural [booktopia.com.au]

  Systemic onset: Fever and rash (salmon-colored) - Macrophage activation syndrome: Hemophagocytic anemia --> Microangiopathy, low fibrinogen, platelets, leukopenia, anemia, high AST/ALT, and VERY high ferritin (>10,000) - Treatment: Prednisone, IL-1 blocker [flashcardmachine.com]

  CBC may show mild anemia. There are several other conditions associated with ankylosing spondylitis. Psoriasis, a skin condition which causes scaly patches on the skin and scalp. It can also lead to a slightly different form of arthritis. [arthritisconsult.com]

  […] increases as posture changes) Chest expansion (reduced as joint fusion increases) -- protuberant abdomen from abdominal breathing Modified Schober test (lumbar spine flexion) Laboratory tests for inflammation in AS Inflammation --> FBC (normochromic/cytic anemia [brainscape.com]

• Relapsing Polychondritis

  polychondritis-associated aortitis. ( 28965131 ) Elourimi G....Abad S. 2017 24 Contrast-enhanced magnetic resonance imaging to detect chronic aortic dissection complicated by acute aortitis. ( 28828099 ) Ouchi K....Yoshitake M. 2017 25 Successful Hybrid [malacards.org]

  Relapsing polychondritis : May manifest as aortic root dilatation and aortitis. Cogan syndrome : Ocular, inner ear, and vascular inflammation. Patients are usually white young adults. Aortitis and valvulitis seen in ~10% of patients. [roentgenrayreader.blogspot.com]

  polychondritis, retroperitoneal fibrosis, rheumatoid arthritis, sarcoidosis, scleroderma, spondylarthropathy, systemic lupus erythematosus, Takayasu arteritis, Wegener granulomatosis Sexual No underlying causes Trauma No underlying causes Urologic No [wikidoc.org]

  Polychondritis.- Clubfoot (Talipes).- Sex of the Offspring.- Women with Large-for-Dates Infants.- Mate Selection.- Malignant Hyperthermia.- Hypokalemia.- Ferritin Secretion.- Rapeseed Oil Disease. [booktopia.com.au]

  Polychondritis.- Clubfoot (Talipes).- Sex of the Offspring.- Women with Large-for-Dates Infants.- Mate Selection.- Malignant Hyperthermia.- Hypokalemia.- Ferritin Secretion.- Rapeseed Oil Disease. show more [bookdepository.com]

• Constitutional Symptom

  symptoms; aortitis; cardiac conduction abnormalities; and anterior uveitis. [msdmanuals.com]

  Symptoms: “abdominal, back and/or flank pain, oliguria and uremia, constipation, claudication and edema of lower limbs and testicular disorders” (453); “Constitutional symptoms and signs such as fever, fatigue, weight loss, anorexia and elevation of ESR [healthyresearcherblog.wordpress.com]

  symptoms AV block Characteristics of AS back pain Insidious onset before 40yrs for longer than 3months Associated with early morning stiffness and improves with exercise May have nocturnal pain Degenerative versus ankylosing spinal changes Degenerative [brainscape.com]

  Constitutional symptoms  Fatigue  Malaise  Fever  Weight loss  Cardiac conduction defects  Aortic insufficiency  Central or peripheral nervous system lesions  Pleuropulmonary infiltrates. 89. [slideshare.net]

  Non-articular manifestations - Mucocutaneous: Keratoderma blennorhagica, circinate balantitis, stomatitis, and nail changes - Aortitis - Amyloidosis - Uveitis - Constitutional symptoms Term Diagnosis of Reactive Arthritis Definition - Lab findings: Anemia [flashcardmachine.com]

• Pleural Effusion

  Effusion, Pleural Fibrosis, Pleural Haemorrhage, Pleuritic Pain, Pleurothotonus, Pneumatosis Cystoides Intestinalis, Pneumocephalus, Pneumomediastinum, Pneumonia, Pneumonia Aspiration, Pneumonia Bacterial, Pneumonia Haemophilus, Pneumonia Mycoplasmal [bonkersinstitute.org]

• Nausea

  Methotrexate (1st line for RA)- Taken once a week SE- nausea & GI upset, bone marrow supression, alveolitis, hepatotoxicity (Given folic acid to help with these) Monitor FBC & LFTs weekly for a month then monthly Teratinogenic (wash out period of 3-6months [slideserve.com]

  […] cases Convulsion - 287 cases Somnolence - 259 cases Overdose - 239 cases Feeling Abnormal - 236 cases Dizziness - 235 cases Fall - 190 cases Gun Shot Wound - 190 cases Headache - 181 cases Insomnia - 181 cases Amnesia - 174 cases Anxiety - 174 cases Nausea [bonkersinstitute.org]

• Vomiting

  Vomiting Projectile, Vulval Cancer, Vulvovaginal Discomfort, Vulvovaginal Disorder, Walking Aid User, Water Pollution, Weight Decreased, Weight Fluctuation, Weight Gain Poor, Weight Increased, Weight Loss Poor, West Nile Viral Infection, Wheelchair [bonkersinstitute.org]

• Diastolic Murmur

  In fact, a diastolic murmur can be audible for several years before dyspnea develops.” (p. 452) “Transesophageal echocardiography is a better imaging technique to visualize the internal structures of the heart.” [healthyresearcherblog.wordpress.com]

• Heart Murmur

  IBD Urethral dc, sexual hx CP, SOB, dry cough, palps, ankle swelling PMH (psoriasis, IBD, heart murmur, lung fibrosis, kidney problems), Fx (psoriasis, IBD, joints/back problems), Dx (including treatments tried), Sx IMPACT on life/work EXAMINE (3 mins [medicaleducationleeds.com]

• Myalgia

  Myalgia or mysoitis - Myalgia is common --> Unclear origin - Myositis is uncommon --> weakness > pain 3. Osteonecrosis --> Avascular necrosis (common) Term Visceral Manifestations of SLE Definition 1. [flashcardmachine.com]

  […] associated with sexually transmitted disease), likely to be more severe in HIV-infected patients with severe polyarticular arthritis, disabling enthesitis and extensive cutaneous manifestations Chief Concern (CC): mucocutaneous lesions, joint stiffness, myalgia [enotes.tripod.com]

  Rigidity, Muscle Spasms, Muscle Spasticity, Muscle Strain, Muscle Tightness, Muscle Twitching, Muscular Weakness, Musculoskeletal Chest Pain, Musculoskeletal Discomfort, Musculoskeletal Disorder, Musculoskeletal Pain, Musculoskeletal Stiffness, Mutism, Myalgia [bonkersinstitute.org]

• Confusion

  Instead they encounter a confusing array of subspecialists divided both by systems and by techniques. [books.google.de]

  There may be considerable systemic disturbance with fever, weight loss and vasomotor changes in the feet. 28 Asymmetric oligoarthritis in lower limbs, usually of acute onset Acute monoarthritis, confused with septic arthritis Sacroiliitis, can be acute [slideplayer.com]

  […] and symmetric, oligoarthritic, DIP joints, ray of hand, and arthritis mutilans (telescoping digit) - Examine skin and nails - Determine if axial disease is present --> Spinal flexion tests - Check for enthesitis and dactylitis - Axial disease can be confused [flashcardmachine.com]

  There is some confusion between diagnostic and classification criteria for SpA. As of now, all criteria that have been developed are classification criteria, although they are sometimes used as diagnostic criteria[ 54 ]. [wjgnet.com]

• Tremor

  Aura, Epistaxis, Epstein-Barr Virus Infection, Erectile Dysfunction, Erection Increased, Eructation, Erythema, Erythema Infectiosum, Erythema Multiforme, Erythropenia, Erythropoiesis Abnormal, Erythropsia, Erythrosis, Essential Hypertension, Essential Tremor [bonkersinstitute.org]

The above X-ray shows the characteristic appearance of the “bamboo spine” that is observed in ankylosing spondylitis ( source ) CLINICAL WORKUP: OTHER HLA Typing: Most all patients who have this condition are HLA-B27 positive. [stepwards.com]

• Atelectasis

  Arthropathy, Arthropod Bite, Ascites, Aseptic Necrosis Bone, Asocial Behaviour, Aspartate Aminotransferase Abnormal, Aspartate Aminotransferase Increased, Asphyxia, Aspiration, Asterixis, Asthenia, Asthenopia, Asthma, Asthmatic Crisis, Astigmatism, Ataxia, Atelectasis [bonkersinstitute.org]

• C-Reactive Protein Increased

  Jaw Malformation, Congenital Nose Malformation, Congenital Ventricular Septal Defect, Conjunctival Haemorrhage, Conjunctival Hyperaemia, Conjunctivitis, Consciousness Fluctuating, Constipation, Contraceptive Diaphragm, Contusion, Conversion Disorder, C-Reactive [bonkersinstitute.org]

• Streptococcus Pneumoniae

  Infectious Bacterial : Salmonella, Staphylococcus, Streptococcus pneumoniae Syphilis : The typical calcification of the ascending aorta is uncommon. Mycobacterial : Mycobacterium tuberculosis Viral : HIV. References Gornik HL, Creager MA. Aortitis. [roentgenrayreader.blogspot.com]

  pneumoniae, syphilis, yaws Musculoskeletal/Orthopedic No underlying causes Neurologic No underlying causes Nutritional/Metabolic No underlying causes Obstetric/Gynecologic No underlying causes Oncologic No underlying causes Ophthalmologic No underlying [wikidoc.org]

• Pleural Effusion

  Effusion, Pleural Fibrosis, Pleural Haemorrhage, Pleuritic Pain, Pleurothotonus, Pneumatosis Cystoides Intestinalis, Pneumocephalus, Pneumomediastinum, Pneumonia, Pneumonia Aspiration, Pneumonia Bacterial, Pneumonia Haemophilus, Pneumonia Mycoplasmal [bonkersinstitute.org]

Its treatment employs endoscopic and/or surgical procedures and administration of corticosteroids, even in association with immunosuppressive agents. [moh-it.pure.elsevier.com]

Leflunomide is recommended for the treatment of active peripheral psoriatic arthritis. [ 9 ] Sulfasalazine may be considered as an alternative in the treatment of peripheral psoriatic arthritis. [ 9 ] Methotrexate may be considered in the treatment of [patient.info]

Is there effective treatment for AS? The most important treatments for AS are daily exercise and anti-inflammatory medications (e.g. Indocid, Naprosyn, Voltaren, Neurofen, Feldene). [austin.org.au]

Treatment of the arthritis of these other spondyloarthropathies is similar to the treatment of reactive arthritis . [merckmanuals.com]

Pathogenesis, symptoms and signs, diagnosis, and treatment differ by etiology. However, the general principle for treatment is to treat the underlying disorder. Resources In This Article [msdmanuals.com]

Both aortitis (with conduction system alterations) and periaortitis should be kept in mind by the physicians because they can significantly influence the prognosis of ankylosing spondylitis patients and they can need a rapid treatment. [moh-it.pure.elsevier.com]

What is the prognosis? Enteropathic Arthritis Arthritis that accompanies inflammatory bowel disease. [slideserve.com]

Whether you are attempting to choose a course of therapy, ascertain the optimal timing for intervention, arrive at a prognosis, or determine the possible need for periodic diagnostic evaluation, this is an essential resource you'll consult time and time [books.google.it]

Prognosis The prognosis for many patients with AS will be complete spinal ankylosis, while others will experience intermittent flares between bouts of clinical remission. [hopkinsarthritis.org]

Pathogenesis, symptoms and signs, diagnosis, and treatment differ by etiology. However, the general principle for treatment is to treat the underlying disorder. Resources In This Article [msdmanuals.com]

Etiology The precise etiology of AS remains mostly unknown, though heritability is frequently cited as a significant contributor. Major histocompatibility alleles, particularly HLA-B27, may account for up to one-third of the genetic effect. [hopkinsarthritis.org]

General Considerations Chronic inflammatory disease of unknown etiology primarily affecting spine Most common spondyloarthropathy Age-young adults 15-35 years Mostly male M:F = 4:1 Mostly Caucasian Caucasians to Blacks = 3:1 Clinical findings Insidious [learningradiology.com]

Pathology Etiology infectious syphilitic aortitis tuberculous aortitis pyogenic aortitis: especially Salmonella infection aortitis due to HIV infected (mycotic) aortic aneurysm non-infectious giant cell arteritis Takayasu arteritis other rheumatologic [radiopaedia.org]

Etiology  Not completely understood  Auto-immune  HLA-B27 : seen in 90 % patients  Autosomal inheritance with 70 % penetration in males  some family history 34. [slideshare.net]

Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty [mdedge.com]

Epidemiology of spondyloarthritis in North America. Am J Med Sci 2011;341(4):284-6. Dillon CF, Hirsch R. The United States National Health and Nutrition Examination Surveyand the epidemiology of ankylosing spondylitis. [hopkinsarthritis.org]

[ 3, 4 ] The diverse clinical manifestations of this condition have impaired meaningful research on epidemiology. [patient.info]

MCP joint destruction with bone resorption and finger shortening (Opera-glass hands) -- this eventually leads to paw like hands with subluxation and loss of function Arthritis effecting up to four joints in the first 6months of the disease classically Epidemiology [brainscape.com]

Focuses on aspects of pathophysiological processes, clinical presentations, screening tests, prognostic implications and novel therapeutic approaches. [books.google.it]

These patients are at high risk of anesthesia related mortality from the pathophysiology of the cardiac lesion, exacerbated by the cardiovascular changes of pregnancy and complicated by the hemodynamic aberrations caused by anesthesia. [unboundmedicine.com]

Clinical and genetic similarities suggest that they also share similar causes or pathophysiologies. Rheumatoid factor (RF) is usually negative in the spondyloarthropathies (hence, why they are called seronegative spondyloarthropathies). [merckmanuals.com]

The pathophysiology probably involves immune-mediated inflammation. [msdmanuals.com]

Ankylosing spondylitis Psoriatic arthritis Reactive arthritis (Reiters) Enteropathicarthritis (associated with IBD) HLA-B27 Ankylosing spondylitis Ankylosing Spondylitis primarily involves the axial skeleton (egsacroiliitis & spondylitis) Prevalence- 0.15% Pathophysiology [slideserve.com]

Can You Prevent AS? Currently, no method of preventing ankylosing spondylitis exists. However, a good stretching and exercise program can delay the normal disease progression. [emedicinehealth.com]

When it comes to ankylosing spondylitis and heart disease, it’s all about prevention, Dr. Steinbaum said. [everydayhealth.com]

Management of aortitis includes controlling the inflammation with medications, treating complications, and preventing its recurrence. [spondylitis.org]

If you pay attention to your posture, exercise regularly and avoid the stoop associated with the condition, you can prevent this from becoming too serious. [arthritisconsult.com]

PATIENT MANAGEMENT: PROPHYLACTIC MEASURES COULD THIS HAVE BEEN PREVENTED? ARCHIVE OF STANDARDIZED EXAM QUESTIONS This archive compiles standardized exam questions that relate to this topic. Page Updated: 02.19.2017 [stepwards.com]