Seronegative spondyloarthritis: Difference between revisions
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|'''[[HLA-B27]]''' | |'''[[HLA-B27]]''' | ||
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|'''[[Psoriatic arthritis]]''' | |'''[[Psoriatic arthritis]]'''<ref name="pmid12421102">{{cite journal| author=Brockbank J, Gladman D| title=Diagnosis and management of psoriatic arthritis. | journal=Drugs | year= 2002 | volume= 62 | issue= 17 | pages= 2447-57 | pmid=12421102 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12421102 }}</ref> | ||
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|'''[[Rheumatoid arthritis]]''' | |'''[[Rheumatoid arthritis]]'''<ref name="pmid15850993">{{cite journal| author=Pham T, Gossec L, Fautrel B, Combe B, Flipo RM, Goupille P et al.| title=Physical examination and laboratory tests in the management of patients with rheumatoid arthritis: development of recommendations for clinical practice based on published evidence and expert opinion. | journal=Joint Bone Spine | year= 2005 | volume= 72 | issue= 3 | pages= 222-8 | pmid=15850993 | doi=10.1016/j.jbspin.2004.10.010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15850993 }}</ref> | ||
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|'''[[Ankylosing spondylitis]]''' | |'''[[Ankylosing spondylitis]]'''<ref name="pmid192973442">{{cite journal| author=Rudwaleit M, van der Heijde D, Landewé R, Listing J, Akkoc N, Brandt J et al.| title=The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. | journal=Ann Rheum Dis | year= 2009 | volume= 68 | issue= 6 | pages= 777-83 | pmid=19297344 | doi=10.1136/ard.2009.108233 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19297344 }}</ref> | ||
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|'''[[Reactive arthritis]] ([[Reiter's syndrome]])''' | |'''[[Reactive arthritis]] ([[Reiter's syndrome]])'''<ref name="pmid6358890">{{cite journal| author=Keat A| title=Reiter's syndrome and reactive arthritis in perspective. | journal=N Engl J Med | year= 1983 | volume= 309 | issue= 26 | pages= 1606-15 | pmid=6358890 | doi=10.1056/NEJM198312293092604 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6358890 }}</ref> | ||
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|'''Juvenile ankylosing spondyloarthritis''' | |'''Juvenile ankylosing spondyloarthritis'''<ref name="pmid21684384">{{cite journal| author=Prakken B, Albani S, Martini A| title=Juvenile idiopathic arthritis. | journal=Lancet | year= 2011 | volume= 377 | issue= 9783 | pages= 2138-49 | pmid=21684384 | doi=10.1016/S0140-6736(11)60244-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21684384 }}</ref> | ||
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Revision as of 23:12, 16 April 2018
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Seronegative spondyloarthritis Main Page |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]
Overview
"Seronegative" refers to the fact that these diseases are negative for Rheumatoid factor and CCP in the serum.
Classification
Algorithm showing classification of seronegative spondyloarthritis[1]
| Seronegative Spondyloarthritis (SpA) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Axial SpA including Ankylosing spondylitis | Peripheral SpA | Psoriatic arthritis | Reactive arthritis | Inflammatory bowel disease related arthritis | Juvenile spondyloarthritis | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Classification Criteria
ASAS classification criteria for axial spondyloarthritis (axial SpA)
The Assessment of SpondyloArthritis International Society classification criteria for axial spondyloarthritis (axial SpA) include:[2]
- Patient with back pain ≥ 3 months and age of onset <45 years should fulfill either of the two criteria:
- Sacroiliitis on imaging* plus ≥ 1 feature of SpA**
- HLA-B27 plus ≥ 2 feature of SpA**
- *Sacroiliitis on imaging:
- Active (acute) inflammation on MRI highly suggestive of sacroiliitis associated with SpA
- OR
- Definite radiographic sacroillitis accorging to modified New York criteria
- **SpA features:
- Inflammatroy back pain
- Arthritis
- Enthesitis (heel)
- Uveitis
- Dactylitis
- Psoriasis
- Crohn's disease or ulcerative colitis
- Good response to NSAIDs
- Family history for SpA
- HLA-B27
- Elevated CRP
- *Sacroiliitis on imaging:
ASAS classification criteria for peripheral spondyloarthritis
- The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis (peripheral SpA) include:[3]
- Arthritis or Enthesitis or Dactylitis
- PLUS ≥ 1 of:
- Psoriasis
- Inflammatory bowel disease
- Preceding infection
- HLA-B27
- Uveitis
- Sacroiliitis on imaging (radiograph or MRI)
- PLUS ≥ 2 of:
- Arthritis
- Enthesitis
- Dactylitis
- Inflammatory back pain in the past
- Positive family history of SpA
Differential Diagnosis
| Arthritis Type | Clinical Features | Body Distribution | Key Signs | Laboratory Abnormalities | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symmetric joint involvement | Asymmetric joint involvement | Enthesopathy | Dactylitis | Nail Dystrophy | Upper extremity-hands | Lower extremity | Sacroiliac joints | Spine | Osteopenia | Joint Space | Ankylosis | Periostitis | Soft tissue swelling | ESR | Rheumatoid factor (RF) | HLA-B27 | |
| Psoriatic arthritis[4] | + | ++ | + | + | + | +++ (DIP/PIP) | +++ | ++ (Unilateral) | ++ | - | ++ (Widening) | ++ | +++ (Fluffy) | ++ | + | - | 30-75% |
| Rheumatoid arthritis[5] | ++ | + | - | - | - | +++ | +++ | + (Unilateral) | ++(Cervical) | +++ | +++ (Narrowing) | + | + (Linear) | +++ | +++ | +++ | 6-8% |
| Ankylosing spondylitis[6] | +++ | - | + | - | - | + | + | +++ (Bilateral) | +++ | +++ | ++ (Narrowing) | +++ | +++ (Fluffy) | + | +++ | - | 90% |
| Reactive arthritis (Reiter's syndrome)[7] | +++ | - | + | + | - | ++ | +++ | ++ (Unilateral) | + | + | + (Narrowing) | - | +++ (Fluffy) | ++ | ++ | - | 75% |
| Inflammatory bowel disease-related arthritis | ++ | + | + | - | ++ | ++ | +++ (Bilateral) | + | + | ++ (Widening) | + | + | + |
++ |
- | 50-75% | |
| Juvenile ankylosing spondyloarthritis[8] | - | ++ | ++ | + | + | + | +++ | +++ | ++ | - | - | +++ | - | ++ | + | - | 90% |
Key:+ : Infrequently present, ++ : Frequently present, +++ : Always present, - : Absent
References
- ↑ Dougados M, Baeten D (2011). "Spondyloarthritis". Lancet. 377 (9783): 2127–37. doi:10.1016/S0140-6736(11)60071-8. PMID 21684383.
- ↑ Rudwaleit M, van der Heijde D, Landewé R, Listing J, Akkoc N, Brandt J; et al. (2009). "The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection". Ann Rheum Dis. 68 (6): 777–83. doi:10.1136/ard.2009.108233. PMID 19297344.
- ↑ Zeidler H, Amor B (2011). "The Assessment in Spondyloarthritis International Society (ASAS) classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general: the spondyloarthritis concept in progress". Ann Rheum Dis. 70 (1): 1–3. doi:10.1136/ard.2010.135889. PMID 21163805.
- ↑ Brockbank J, Gladman D (2002). "Diagnosis and management of psoriatic arthritis". Drugs. 62 (17): 2447–57. PMID 12421102.
- ↑ Pham T, Gossec L, Fautrel B, Combe B, Flipo RM, Goupille P; et al. (2005). "Physical examination and laboratory tests in the management of patients with rheumatoid arthritis: development of recommendations for clinical practice based on published evidence and expert opinion". Joint Bone Spine. 72 (3): 222–8. doi:10.1016/j.jbspin.2004.10.010. PMID 15850993.
- ↑ Rudwaleit M, van der Heijde D, Landewé R, Listing J, Akkoc N, Brandt J; et al. (2009). "The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection". Ann Rheum Dis. 68 (6): 777–83. doi:10.1136/ard.2009.108233. PMID 19297344.
- ↑ Keat A (1983). "Reiter's syndrome and reactive arthritis in perspective". N Engl J Med. 309 (26): 1606–15. doi:10.1056/NEJM198312293092604. PMID 6358890.
- ↑ Prakken B, Albani S, Martini A (2011). "Juvenile idiopathic arthritis". Lancet. 377 (9783): 2138–49. doi:10.1016/S0140-6736(11)60244-4. PMID 21684384.