SERONEGATIVE ARTHERITIS in details presentation.pptx

sero negative artheritis

1. SERO NEGATIVE ARTHRITIS DR SARMISTHA PAL MD GENERAL MEDICINE 2 ND YEAR PGT PATNA MEDICAL COLLEGE

2. SERO-NEGATIVE ARTHRITIS Negative for RHEUMATOID FACTOR or other autoantibody or serological abnormalities SPONDYLOARTHROPATHIES Definition: A group of inflammatory arthropathies that share distinctive clinical, radiographic and genetic features. These diagnoses include: 1. ANKYLOSING SPONDYLITIS (AS) 2. REACTIVE ARTHRITIS (REA) 3. PSORIATIC ARTHRITIS (PSA) 4. ENTEROPATHIC ARTHRITIS

3. arthritis Sharing distinctive clinical, radiographic and genetic features

4. . COMMON FEATURES Seronegative (i.e. Rheumatoid Factor Is Absent). Rheumatoid nodules are absent. Frequent association of HLA-B27. A tendency to occur in same family (familial aggregation). Inflammatory axial arthritis, generally Sacroiliitis and Spondylitis. Oligoarthritis generally with asymmetrical presentation. Enthesitis (inflammation of the entheses , the sites where tendons or ligaments insert into the bone) e.g. Plantar fasciitis, Achilles tendonitis, costochondritis . Extra-articular features, such as involvement of eyes (anterior uveitis), skin, genitourinary tract.

5. . Associations with HLA-B27 Rheumatic diseases [ Degree of Associations ] Ankylosing spondylitis - >90% Reiter's syndrome/ Reactive arthritis - >80% IBD related arthritis - ~75% Psoriatic arthritis - ~50%

6. ANKYLOSING SPONDYLITIS It is an Chronic inflammatory disorder of unknown cause that primarily affects the Axial skeleton, peripheral joints and extraarticular structures. 90% of patients are HLA-B27 positive. Incidence - Men:women 3:1 Age of onset typically between 20 and 40 years. More commonly involves the axial skeleton, although peripheral joints may also be affected.

7. Pathology Sacroiliitis is the earliest manifestation of AS. Synovitis , Pannus , Myxoid marrow, subchondral granulation tissue and marrow edema are found. In Spine, there is inflammatory granulation tissue at the junction of annulus fibrosis and vertebral bone. The outer annular fibers are eroded and replaced by bone, forming a syndesmophyte .