Abstract
Inflammatory arthritides are systemic diseases characterized by synovial inflammation as well as cartilage and bone destruction, accompanied by increased levels of acute-phase reactants. They can be seropositive or seronegative based on the presence or absence of rheumatoid factor and/or anti-cyclic citrullinated peptide antibodies, respectively. Rheumatoid arthritis (RA) is the prototype seropositive arthritis. RA is characterized by extensive synovitis resulting in articular cartilage erosions and joint destruction and presents as symmetrical arthritis of small and large joints along with a wide spectrum of extra-articular manifestations.
Seronegative spondyloarthropathies include psoriatic arthritis (PsA), ankylosing spondylitis (AS), enteropathic arthritis, post-infectious (reactive) arthritis, adult-onset Still’s disease, juvenile idiopathic arthritis, and juvenile spondyloarthropathy. Type and location of articular involvement, extra-articular and systemic manifestations, as well as findings from joint imaging are important in distinguishing different types of arthritis. Sacroiliac joint and spine involvement alone or accompanied by asymmetrical arthritis of large peripheral joints and enthesitis are seen more often in seronegative spondyloarthropathies. Psoriasis and psoriatic nail changes are frequently encountered in PsA patients. Keratoderma blennorrhagicum, conjunctivitis, and uveitis are some of the extra-articular manifestations of reactive arthritis. Enteropathic arthritis, seen in patients with Crohn’s disease or ulcerative colitis, can affect the spine, sacroiliac joints, and large peripheral joints. Tropheryma whipplei, parvovirus 19, hepatitis B and C virus infection, Borrelia burgdorferi, and disseminated gonococcal infection are associated with arthritis, which is sometimes difficult to distinguish from inflammatory arthritis. Rheumatic fever, a sequel of group A streptococcal pharyngitis, manifests with febrile migratory polyarthritis, myocarditis, valvular heart disease, erythema marginatum, and chorea.
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Moutsopoulos, H.M., Zampeli, E., Vlachoyiannopoulos, P.G. (2018). Inflammatory Arthritides. In: Rheumatology in Questions. Springer, Cham. https://doi.org/10.1007/978-3-319-71604-6_3
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DOI: https://doi.org/10.1007/978-3-319-71604-6_3
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