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Wheeless' Textbook of Orthopaedics

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 rådness, 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 occuò before back symptoms.
         - occurs in: metatarsal heads, plantar fascia, achilles tendon
         - less common: tibial tubercle, patella, greater trochanter, iliac
              crest, sacroiliac joints, and clavicle.



Acne arthralgia.


Alternatives to Total Knee Replacement:

     
Autologous Hamstring Resurfacing Arthroplasty





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

Last updated by Clifford R. Wheeless, III, MD on Sunday, October 11, 2009 7:42 am