Info on seronegative spondyloarthropathies, including Sx, Ix, Dx, Mx
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Inflammatory condition mainly affecting the spine, causing fusion
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Causes stiffness and pain
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Main joints involved = SI joints and vertebral column
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90% have HLA-B27 gene
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Raised CRP + ESR
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HLA-B27
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Schober test
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Assesses mobility of spine between 10cm above L5 and 5cm below
<20cm indicates a restriction |
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XR changes
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Bamboo spine
Squaring of vertebral bodies subchondral sclerosis + eriosions Syndesmophytes ossification fusion of facet, SI and costovertebral joints |
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MRI
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Bone marrow oedema
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Medication
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NSAIDs
Steroids in flares Anti-TNF or monoclonals (etanercept, infliximab) Secukinumab (against IL-17) |
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Other
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Physio
Exercise Avoid smoking Bisphosphonates Treat complications Surgery if deformities |
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20 year old, gradual spinal stiffness over >3 months
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Lower back pain + stiffness
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Worse with rest/at night/in morning
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Takes 30 minutes for pain to improve in morning
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Experience flare ups
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Vertebral fractures
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Bamboo spine
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Systemic
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Weight loss, fatigue
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Chest pain
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Enthesitis
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Plantar fasciitis, achilles tendonitis
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Dactylitis
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Anaemia
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Anterior uveitis
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Aortitis
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Heart block
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Restrictive lung disease
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Pulmonary fibrosis of upper lobes
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IBD
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