Enteropathic arthropathy: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
Kalsang Dolma (talk | contribs)
nocaptcha
22,673 edits
Created page with "__NOTOC__ {{SI}} {{CMG}} {{AE}} {{KD}} ==Overview== '''Enteropathic arthropathy''' or arthritis refers to acute or subacute arthritis in association with or as a reaction to a..."
 
Ajay Gade (talk | contribs)
nocaptcha
1,722 edits
 
(21 intermediate revisions by 2 users not shown)
Line 3: Line 3:
{{CMG}} {{AE}} {{KD}}
{{CMG}} {{AE}} {{KD}}
==Overview==
==Overview==
'''Enteropathic arthropathy''' or arthritis refers to acute or subacute arthritis in association with or as a reaction to an enteric (usually colonic) inflammatory condition.
'''Enteropathic arthropathy''' or Enteropathic arthritis refers to [[acute]] or [[subacute]] [[arthritis]] in association with or as a reaction to an [[enteric]] (usually colonic) [[inflammatory]] condition.
 
==Classification==
*Axial
**[[Sacroiliitis|Sacroilitis]]
**[[Spondylitis]]
 
*Peripheral arthritis
*'''Type I Arthropathy'''
**Less than five joints involved
**[[Acute]]
**Less than 10 weeks
**Asymmetrical
**Shoulder, hips and knee joints are involved
*'''Type II Arthropathy'''
**More than five joints involved
**[[Chronic (medical)|Chronic]]
**Months to years
**Symmetrical
**Small joints are involved.
 
==Pathophysiology==
==Pathophysiology==
Causes/Associations:
 
==Risk factors==
*[[HLA-B27]] positive people
*Active [[inflammatory bowel disease]] (IBD)
*Positive family history
*Tobacco smoking
 
==Causes==
* [[Reactive arthritis]] (Reactive to enteric infection)
* [[Reactive arthritis]] (Reactive to enteric infection)
* Spondyloarthropathies associated with inflammatory bowel disease (Crohn disease and ulcerative colitis)
* [[Spondyloarthropathies]] associated with [[inflammatory bowel disease]] ([[Crohn disease]] and [[ulcerative colitis]])
* Malabsorption related: Intestinal bypass (jejunoileal), Celiac disease, Whipple disease
* [[Malabsorption]] related: Intestinal bypass ([[Jejuno-ileal bypass|jejunoileal]]), [[Celiac disease]], [[Whipple's disease|Whipple disease]]
* Collagenous colitis
* [[Collagenous colitis]]
 
==Differential diagnosis==
The Differential diagnosis of enteropathic arthritis are as follows:
*[[Reactive arthritis]]
*[[Psoriatic arthritis]]
*[[Ankylosing spondylitis]]
*[[Rheumatoid arthritis]]
*[[Lyme disease]]
*[[Behçet's disease|Behcet's disease]]
*[[Gout]]
*[[Sarcoidosis]]
*[[Septic arthritis]]
 
==Signs and Symptoms==
*'''[[Sacroiliitis]] and [[Spondylitis]]'''- Low back pain exacerbated on sitting and standing for a prolonged period and relieved by activity.
*'''[[Enthesitis]]'''-  [[Inflammation]] of the [[tendon]] at the insertion of the bone such as [[tibial tuberosity]], [[achilles tendon]] at the heel.
*'''Dactilitis'''- [[Inflammation]] of the digit.
*'''Type I Arthropathy'''
**Less than five joints involved
**[[Acute]]
**Less than 10 weeks
**Asymmetrical
**Shoulder, hips and knee joints are involved
*'''Type II Arthropathy'''
**More than five joints involved
**[[Chronic (medical)|Chronic]]
**Months to years
**Symmetrical
**Small joints are involved.
*'''Extra Articular'''
**[[Aphthous ulcer|Aphthous ulcers]]
**[[Uveitis]]
**Fever
**Weight loss
**Abdominal pain
**[[Diarrhea]]
**[[Pyoderma gangrenosum]]
**[[Erythema nodosum]]
 
==Physical Examination==
The physical examination findings of a patient with Enteropathic arthropathy include:<ref name="pmid26557891">{{cite journal |vauthors=Ha F, Khalil H |title=Crohn's disease: a clinical update |journal=Therap Adv Gastroenterol |volume=8 |issue=6 |pages=352–9 |year=2015 |pmid=26557891 |pmc=4622286 |doi=10.1177/1756283X15592585 |url=}}</ref><ref name="pmid22230271">{{cite journal |vauthors=Wilkins T, Jarvis K, Patel J |title=Diagnosis and management of Crohn's disease |journal=Am Fam Physician |volume=84 |issue=12 |pages=1365–75 |year=2011 |pmid=22230271 |doi= |url=}}</ref><ref name="pmid23634187">{{cite journal |vauthors=Donnellan CF, Yann LH, Lal S |title=Nutritional management of Crohn's disease |journal=Therap Adv Gastroenterol |volume=6 |issue=3 |pages=231–42 |year=2013 |pmid=23634187 |pmc=3625021 |doi=10.1177/1756283X13477715 |url=}}</ref><ref name="pmid19568370">{{cite journal |vauthors=Baumgart DC |title=The diagnosis and treatment of Crohn's disease and ulcerative colitis |journal=Dtsch Arztebl Int |volume=106 |issue=8 |pages=123–33 |year=2009 |pmid=19568370 |pmc=2695363 |doi=10.3238/arztebl.2009.0123 |url=}}</ref>
 
===General Appearance===
*[[Weakness]]
*[[Fatigue]]
 
===Vitals===
*[[Fever]]
*[[Tachycardia]]
 
===HEENT===
*[[Aphthous ulcers]]
*[[Episcleritis]] and [[uveitis]]
 
===Cardiovascular System===
*Normal S1 and S2 sounds
*[[Tachycardia]]
 
===Gastrointestinal System===
*Abdominal tenderness in the right lower quadrant
*Abdominal distension
 
===Skin===
*[[Erythema nodosum]]
*[[Pyoderma gangrenosum]]
 
===Musculoskeletal System===
*Inflammation of the joints.
*[[Enthesitis]]
*[[Dactilitis]]
 
==Laboratory Findings==
The laboratory tests for the Enteropathic arthritis are as follows:<ref>{{cite journal | last = Kaila | first = B. | coauthors = K. Orr and C. N. Bernstein | year = 2005 | month = December | title = The anti-Saccharomyces cerevisiae antibody assay in a province-wide practice: accurate in identifying cases of Crohn's disease and predicting inflammatory disease | journal = The Canadian Journal of Gastroenterology | volume = 19 | issue = 12 | pages = 717-21 | id = PMID 16341311 | url =http://www.pulsus.com/Gastro/19_12/kail_ed.htm | accessdate = 2006-07-02 }}</ref><ref>{{cite journal | last = Israeli | first = E. | coauthors = I. Grotto, B. Gilburd, R. D. Balicer, E. Goldin, A. Wiik and Y. Shoenfeld | year = 2005 | month = September | title = Anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic antibodies as predictors of inflammatory bowel disease | journal = Gut | volume = 54 | issue = 9 | pages = 1232-6 | doi =10.1136/gut.2004.060228 | id = PMID 16099791 }}</ref>
{| class="wikitable"
!Laboratory tests
!Findings
|-
|CBC
|
* [[Anemia]]
* [[Leucocytosis]]
* [[Thrombocytosis]]
|-
|Iron studies
|
* + [[Iron deficiency anemia]]
|-
|Serum Vit B12
|
* Normal or low
|-
|[null Serum folate]
|
* Normal or low
|-
|CMP
|
* [[Hypoalbuminemia]]
* [[Hypocalcemia]]
 
|-
|CRP and ESR
|
* Elevated
|-
|Stool testing
|
* Negative for infectious elements
|-
|Yersinia serology
|
* Negative
|}
 
==Diagnostic test of choice==
 
 
==Medical Therapy==
'''Non-Pharmacological therapy'''
*[[Physiotherapy]] including spinal mobility exercises
*Diet specific for IBD patients
*Referral to [[Ophthalmologist]] for the [[Anterior uveitis|anterior uveitis.]]
 
'''Pharmacological therapy'''
*[[Non-steroidal anti-inflammatory drug|Non-steroidal anti-inflammatory drug (NSAIDS]])
*[[Corticosteroids]]
**[[Intraarticular|Intraarticular corticosteroids]]
**Systemic corticosteroids
*[[Sulfasalazine]]
*[[Methotrexate]]
*[[Azathioprine]]
*[[Pamidronate]]
*[[Cyclosporine|Ciclosporin]]
*[[Tumor necrosis factors|Tumour necrosis factor (TNF) antagonists]]
 
 


Note that reactive arthritis can also occur secondary to urethral infection. In that case the term enteropathic arthropathy would not be used.
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Infectious arthropathies]]
[[Category: Infectious arthropathies]]
[[Category:Inflammatory polyarthropathies]]
[[Category: Inflammatory polyarthropathies]]
{{WH}}
{{WS}}

Latest revision as of 21:47, 19 April 2018

WikiDoc Resources for Enteropathic arthropathy

Articles

Most recent articles on Enteropathic arthropathy

Most cited articles on Enteropathic arthropathy

Review articles on Enteropathic arthropathy

Articles on Enteropathic arthropathy in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Enteropathic arthropathy

Images of Enteropathic arthropathy

Photos of Enteropathic arthropathy

Podcasts & MP3s on Enteropathic arthropathy

Videos on Enteropathic arthropathy

Evidence Based Medicine

Cochrane Collaboration on Enteropathic arthropathy

Bandolier on Enteropathic arthropathy

TRIP on Enteropathic arthropathy

Clinical Trials

Ongoing Trials on Enteropathic arthropathy at Clinical Trials.gov

Trial results on Enteropathic arthropathy

Clinical Trials on Enteropathic arthropathy at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Enteropathic arthropathy

NICE Guidance on Enteropathic arthropathy

NHS PRODIGY Guidance

FDA on Enteropathic arthropathy

CDC on Enteropathic arthropathy

Books

Books on Enteropathic arthropathy

News

Enteropathic arthropathy in the news

Be alerted to news on Enteropathic arthropathy

News trends on Enteropathic arthropathy

Commentary

Blogs on Enteropathic arthropathy

Definitions

Definitions of Enteropathic arthropathy

Patient Resources / Community

Patient resources on Enteropathic arthropathy

Discussion groups on Enteropathic arthropathy

Patient Handouts on Enteropathic arthropathy

Directions to Hospitals Treating Enteropathic arthropathy

Risk calculators and risk factors for Enteropathic arthropathy

Healthcare Provider Resources

Symptoms of Enteropathic arthropathy

Causes & Risk Factors for Enteropathic arthropathy

Diagnostic studies for Enteropathic arthropathy

Treatment of Enteropathic arthropathy

Continuing Medical Education (CME)

CME Programs on Enteropathic arthropathy

International

Enteropathic arthropathy en Espanol

Enteropathic arthropathy en Francais

Business

Enteropathic arthropathy in the Marketplace

Patents on Enteropathic arthropathy

Experimental / Informatics

List of terms related to Enteropathic arthropathy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]

Overview

Enteropathic arthropathy or Enteropathic arthritis refers to acute or subacute arthritis in association with or as a reaction to an enteric (usually colonic) inflammatory condition.

Classification

  • Peripheral arthritis
  • Type I Arthropathy
    • Less than five joints involved
    • Acute
    • Less than 10 weeks
    • Asymmetrical
    • Shoulder, hips and knee joints are involved
  • Type II Arthropathy
    • More than five joints involved
    • Chronic
    • Months to years
    • Symmetrical
    • Small joints are involved.

Pathophysiology

Risk factors

Causes

Differential diagnosis

The Differential diagnosis of enteropathic arthritis are as follows:

Signs and Symptoms

Physical Examination

The physical examination findings of a patient with Enteropathic arthropathy include:[1][2][3][4]

General Appearance

Vitals

HEENT

Cardiovascular System

Gastrointestinal System

  • Abdominal tenderness in the right lower quadrant
  • Abdominal distension

Skin

Musculoskeletal System

Laboratory Findings

The laboratory tests for the Enteropathic arthritis are as follows:[5][6]

Laboratory tests Findings
CBC
Iron studies
Serum Vit B12
  • Normal or low
[null Serum folate]
  • Normal or low
CMP
CRP and ESR
  • Elevated
Stool testing
  • Negative for infectious elements
Yersinia serology
  • Negative

Diagnostic test of choice

Medical Therapy

Non-Pharmacological therapy

Pharmacological therapy


References

  1. ↑ Ha F, Khalil H (2015). "Crohn's disease: a clinical update". Therap Adv Gastroenterol. 8 (6): 352–9. doi:10.1177/1756283X15592585. PMC 4622286. PMID 26557891.
  2. ↑ Wilkins T, Jarvis K, Patel J (2011). "Diagnosis and management of Crohn's disease". Am Fam Physician. 84 (12): 1365–75. PMID 22230271.
  3. ↑ Donnellan CF, Yann LH, Lal S (2013). "Nutritional management of Crohn's disease". Therap Adv Gastroenterol. 6 (3): 231–42. doi:10.1177/1756283X13477715. PMC 3625021. PMID 23634187.
  4. ↑ Baumgart DC (2009). "The diagnosis and treatment of Crohn's disease and ulcerative colitis". Dtsch Arztebl Int. 106 (8): 123–33. doi:10.3238/arztebl.2009.0123. PMC 2695363. PMID 19568370.
  5. ↑ Kaila, B. (2005). "The anti-Saccharomyces cerevisiae antibody assay in a province-wide practice: accurate in identifying cases of Crohn's disease and predicting inflammatory disease". The Canadian Journal of Gastroenterology. 19 (12): 717–21. PMID 16341311. Retrieved 2006-07-02. Unknown parameter |month= ignored (help); Unknown parameter |coauthors= ignored (help)
  6. ↑ Israeli, E. (2005). "Anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic antibodies as predictors of inflammatory bowel disease". Gut. 54 (9): 1232–6. doi:10.1136/gut.2004.060228. PMID 16099791. Unknown parameter |coauthors= ignored (help); Unknown parameter |month= ignored (help)

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Enteropathic_arthropathy&oldid=1464382"