This document summarizes several types of inflammatory and infectious arthritis. It describes seronegative spondyloarthritis as arthritis that is negative for rheumatoid factor but affects the sacroiliac joints and spine, often associated with HLA-B27. Ankylosing spondylitis is a type of seronegative spondyloarthritis that causes chronic inflammation of the lumbar and sacroiliac regions. Reactive arthritis and Reiter's syndrome can develop after genitourinary or gastrointestinal infections and present as a triad of arthritis, urethritis, and conjunctivitis. Psoriatic arthritis is associated with the skin condition psoriasis. Suppurative arthritis is caused by bacterial infections like

1. JOINTS 2
Sero -ve
Spondyloarthritis
Feature
negative RF
sarcoiliac & spine
HLA- B27
Ankylosing spondylitis
Reactive arthritis
Reiter's
Enteropathic
Psoriatic arthritis
Ank.
Spond.
Feature
Chr. inflam. of lumbar & sacroiliac
Patho = HLA B-27
Age = young males
Effect
Perip. arthritis
Uveitis
Aortic incompetence
Reiter's
Feature
Patho = HLA B-27
Patho = autoimmune cond.
Age = young males
Causes
Genitourinary infection
GIT infection
Effect:
Triad
Arthritis at knees, ankles
Urethritis
Conjunctivitis
Enteropat.
Arthritis
Cause = Chr. IDB (Crohn & UC)
Ifxn causes
Salmonella, shigella
Yersinia, campylobact.
Psoriatic
Arthritis
Cause = psoriasis
Patho = HLA B-27
Site = DIP, knees, spine
Infec. Arthritis Patho
Haematogenous
Adjacent infec. foci
DIrect inoculation
trauma
surgical
Suppur.
Arthritis
Causes
Staph. aureus (most common & destructive)
H.Influenza (< 2 yo)
Gonococcus (in young sex. active)
Streptococci
E. coli & pseudomonas
Effect
Acutely painful, swollen joint
Fever
Raised WBC
TB
Arthritis
Patho = adjacent TB osteomyelitis or haematogen.
Site = spine, hip
Destructive arthritis
Typical granulomatous inflammation
Gout
Arthritis
Feature
Epid. = male in 50's
RF = familial, alcohol, obesity
Patho = disorder of purine metab.
Site = metatarsophalangeal joint
Effect = hyperuricaemia
Cause
Primary
undersecretion of uric acid
over production of uric acid
2ndary
excess. brkdown of nuc. acid
renal undersecretion
enzyme deficiency (HGPRT)
Patho
Urate crystal deposition on artic. surface
Interaction with leucocyte -- degen. changes
Deposit. in tissue cause tophus formation
Dx
Synov. aspirate = needle shaped crystal
Synov. biopsy
Tx
Clochicine (anti inflam.)
Allopurinol (inhib. uric acid synthesis)
Hydration (promote renal excretion)
JOINTS 2.mmap - 06/01/2010 - Mindjet