The Hip: Preservation, Replacement and Revision

Spondyloarthropathies / Related Chronic Seronegative Arthritides



- Discussion:
    - conditions include:
           - AS
           - Reiter's Syndrome
           - Psoriatic Arthritis
           - Inflammatory Bowel Disease
    - typically involves the axial skeleton;
    - affected areas heal w/ fibroblastic proliferation followed by new bone formation;
    - pathogenesis of these disorders is unknown except for Reiter's syndrome, which is generally believed to result from aberrant host response to a pathogenic microorganism;

- Labs:
    - RF is negative;
    - HLA-B27 phenotype:
           - typically possitive in seronegative arthritis;
           - typically negative in RA;

- Clinical Manifestations:
    - Systemic manifestions:
         - low grade fever, malaise, wt loss, aortitis.
         - look for AR
    - Iritis:
         - iritis assoc seronegative spondyloarthropathies is acute inflammatory process causing redness, pain, and photophobia. (in contrast to JRA it is self limiting and rarely leads to visual impairment.)
    - Enthesopathy:
         - pain at ligament and tendon insertions;
         - seen frequently, may occur before back symptoms.
         - occurs in: metatarsal heads, plantar fascia, achilles tendon
         - less common: tibial tubercle, patella, greater trochanter, iliac crest, sacroiliac joints, and clavicle.


References

Acne arthralgia.

Alternatives to Total Knee Replacement: Autologous Hamstring Resurfacing Arthroplasty



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, August 21, 2012 4:42 pm