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Spondyloarthropathies / Related Chronic Seronegative Arthritides

Discussion

  • onditions include:
  • 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