Spondylo-arthritis
Aetiology
Reiter's syndrome
- Infection (chlamydia)
Ankylosis spondylitis
- Inflammatory condition affecting sacroiliac joint/ spine
Clinical Features
Reactive arthritis:
Symptoms
- Painful red eye (ant uveitis)
- Sore archilles tendon
- Travel Hx
Signs
- Injected eye with exudate in anterior chamber
Investigations
Bloods:
- FBC, ESR, CRP, autoimmune screens, HLA B27 (common-8%)
Imaging:
- X ray (bamboo spine/ excess kyphosis = AS)
- CT
- Bone scan (hot)
Others:
- PCR chlamydia
DDx
- Osteomyelitis
- Myeloma
- Ankylosing Spondylitis
- Infective (TB, rickettsia, Q fever)
- Disc prolapse
- Trauma
Treatment
- Treat cause (if Reiter's)
- Physiotherapy*** (important - once mobility lost, can't get it back)
- Doxycycline (chlamydia)
- NSAIDs
- Steroids
- Sulfasalazine (1st line)
- DMARDS
Source
Dr Alasdair MacDonald 2014