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Spondyloarthropathy

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81. Ankylosing spondylitis

Ankylosing spondylitis Ankylosing spondylitis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Ankylosing spondylitis Last reviewed: February 2019 Last updated: November 2018 Summary Classified as a seronegative spondyloarthropathy. The seronegative spondyloarthropathies (including psoriatic arthritis, enteropathic arthritis, and reactive arthritis) are a heterogenous group of conditions with overlapping clinical

2018 BMJ Best Practice

82. Assessment of dysuria

or catheterisation Sexual abuse Athletics Interstitial cystitis Atrophic vaginitis Spondyloarthropathies Non-infectious prostatitis Ketamine bladder Urinary fistula Prostate cancer Bladder cancer Renal cancer Cervical cancer Urethral cancer Penile cancer Drugs or herbs Depression Somatisation disorder (urethral hypersensitivity) Contributors Authors Consultant Urologist Cambridge University Hospitals NHS Foundation Trust Cambridge UK Honorary Lecturer Anglia Ruskin University Cambridge UK Disclosures KS-P

2018 BMJ Best Practice

83. Assessment of back pain

strain/sprain Herniated nucleus pulposus Spinal stenosis Compression fracture Degenerative disc disease or facet arthropathy Sacroiliitis Spondylolysis and/or spondylolisthesis Vertebral discitis/osteomyelitis Malignancy Inflammatory spondyloarthropathy Connective tissue disease Aortic abdominal aneurysm Pancreatitis Pyelonephritis Renal colic Peptic ulcer disease Contributors Authors Associate Professor Department of Orthopedic Surgery William Beaumont Hospital Royal Oak MI Disclosures DKP is a paid

2018 BMJ Best Practice

84. Assessment of seronegative arthritis

physical examination should enable the diagnosis to be elucidated in most patients. Supporting or confirmatory data are obtained from laboratory and imaging studies. Spondyloarthropathies, crystalline and viral arthropathies, and rheumatoid arthritis are the most common diagnoses in these patients. Savolainen E, Kaipiainen-Seppanen O, Kroger L, et al. Total incidence and distribution of inflammatory joint diseases in a defined population: results from the Kuopio 2000 arthritis survey. J Rheumatol (...) Undifferentiated spondyloarthropathy Calcium pyrophosphate deposition disease (CPPD) Gout Polymyalgia rheumatica Osteoarthritis Rheumatoid arthritis Systemic lupus erythematosus Septic arthritis Bacterial endocarditis Viral arthritis Enteropathic arthritis Remitting seronegative symmetric synovitis with pitting oedema syndrome Sarcoidosis Juvenile-onset or adult-onset idiopathic arthritis Overlap syndrome Sjogren's syndrome Scleroderma Polymyositis Dermatomyositis Systemic vasculitis Gonococcal arthritis

2018 BMJ Best Practice

85. Ankylosing spondylitis

Ankylosing spondylitis Ankylosing spondylitis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Ankylosing spondylitis Last reviewed: February 2019 Last updated: November 2018 Summary Classified as a seronegative spondyloarthropathy. The seronegative spondyloarthropathies (including psoriatic arthritis, enteropathic arthritis, and reactive arthritis) are a heterogenous group of conditions with overlapping clinical

2018 BMJ Best Practice

86. Assessment of inflamed joint

infections Parvoviral syndrome Lyme disease Juvenile idiopathic arthritis (oligo-articular type) Acute rheumatic fever (ARF) Sarcoidosis Spondyloarthropathy Systemic lupus erythematosus (SLE) Adult-onset Still's disease (AOSD) Reactive arthritis Ankylosing spondylitis (AS) Osteoarthritis Trauma Non-traumatic haemarthrosis Hypertrophic osteoarthropathy Intra-articular metastatic cancer Synovial sarcoma Arbovirus infections (e.g., chikungunya) Inflammatory bowel disease (ulcerative colitis and Crohn's

2018 BMJ Best Practice

87. Chikungunya virus infection

by polyarthritis and systemic manifestations that may last for months or years and may resemble rheumatoid arthritis or a seronegative spondyloarthropathy. Has a global distribution, thanks to a genetic change enabling the virus to be transmitted by Aedes albopictus (a more widespread Aedes vector), as well as Aedes aegypti . Locally acquired cases have been reported in the US and Europe. Diagnosis is based on clinical manifestations and epidemiological clues. Confirmation is via serological detection

2018 BMJ Best Practice

88. Assessment of inflamed joint

infections Parvoviral syndrome Lyme disease Juvenile idiopathic arthritis (oligo-articular type) Acute rheumatic fever (ARF) Sarcoidosis Spondyloarthropathy Systemic lupus erythematosus (SLE) Adult-onset Still's disease (AOSD) Reactive arthritis Ankylosing spondylitis (AS) Osteoarthritis Trauma Non-traumatic haemarthrosis Hypertrophic osteoarthropathy Intra-articular metastatic cancer Synovial sarcoma Arbovirus infections (e.g., chikungunya) Inflammatory bowel disease (ulcerative colitis and Crohn's

2018 BMJ Best Practice

89. Reactive arthritis

syndrome' has fallen out of favour because of his ties to the Nazi Party and medical experiments on concentration camp prisoners. Lu DW, Katz KA. Declining use of the eponym "Reiter's syndrome" in the medical literature, 1998-2003. J Am Acad Dermatol. 2005;53:720-723. http://www.ncbi.nlm.nih.gov/pubmed/16198806?tool=bestpractice.com ReA belongs to the family of spondyloarthropathies, which share similar clinical, radiographic, and laboratory features that include spinal inflammation and an association (...) with HLA-B27. They include psoriatic arthritis, ankylosing spondylitis, arthritis related to inflammatory bowel disease, and undifferentiated spondyloarthropathy. History and exam presence of risk factors peripheral arthritis axial arthritis constitutional symptoms enthesitis mucous membrane involvement skin rash circinate balanitis ocular manifestations cardiac manifestations male sex HLA-B27 genotype preceding chlamydial or GI infection Diagnostic investigations ESR C-reactive protein (CRP) ANA

2018 BMJ Best Practice

90. AIM Clinical Appropriateness Guidelines for Interventional Pain Management

is associated with inflammatory spondyloarthropathies. Pain arising from the SI joint complex typically radiates to the gluteal area and posterior hip. In addition to localized tenderness over the SI joint, there are additional examination maneuvers which suggest the diagnosis. General Requirements Conservative management should include a combination of strategies to reduce inflammation, alleviate pain, and improve function, including but not limited to the following: ? Prescription strength anti

2019 AIM Specialty Health

91. Spine imaging

Infectious and Inflammatory Conditions 12 Juvenile idiopathic arthritis (Pediatric only) 12 Multiple sclerosis or other white matter disease 12 Rheumatoid arthritis (Adult only) 12 Spinal infection 13 Spondyloarthropathy 13 Trauma 14 Cervical injury 14 Thoracic or lumbar injury 14 Tumor 15 Tumor 15 Miscellaneous Conditions of the Spine 15 Osteoporosis and osteopenia 15 Spinal cord infarction 16 Spondylolysis and spondylolisthesis 16 Syringomyelia 16 Signs and Symptoms 16 Cauda equina syndrome 16 (...) to epidural abscess, arachnoiditis, discitis, and osteomyelitis. IMAGING STUDY - CT or MRI all spinal levels - FDG-PET for chronic osteomyelitis Spondyloarthropathy Includes ankylosing spondylitis, reactive arthritis, psoriatic arthritis, spondyloarthropathy associated with inflammatory bowel disease, and juvenile-onset spondyloarthritis Advanced imaging of the spine is considered medically necessary for diagnosis following standard evaluation with radiographs and/or laboratory evaluation. IMAGING STUDY

2019 AIM Specialty Health

92. Appropriate Use Criteria: Imaging of the Abdomen and Pelvis

16 Intussusception (Pediatric only) 16 Ischemic bowel 17 Hepatobiliary Conditions 17 Ascites 17 Biliary tract dilatation or obstruction 17 Cholecystitis 17 Imaging of the Abdomen and Pelvis Copyright © 2019. AIM Specialty Health. All Rights Reserved. 3 Choledocholithiasis 18 Diffuse liver disease 18 Focal liver lesion 19 Hepatomegaly 20 Jaundice 20 Primary sclerosing cholangitis 21 Osseous Conditions 21 Avascular necrosis 21 Axial spondyloarthropathy 21 Developmental hip dysplasia (Pediatric only (...) planning for osteonecrosis with femoral head collapse IMAGING STUDY - MRI pelvis - CT pelvis when MRI or bone scan not available or contraindicated Axial spondyloarthropathy Advanced imaging is considered medically necessary in ANY of the following scenarios: ? Diagnosis of nonradiographic spondyloarthropathy (nrSpA) when BOTH of the following are present: o Radiographs which are negative or equivocal for sacroiliitis (Grade 0-2) o Inflammatory back pain which has been present for at least 3 months

2019 AIM Specialty Health

93. AGA Clinical Practice Guidelines on the Management of Mild-to-Moderate Ulcerative Colitis

for laboratory monitoring. However, sulfasalazine is commonly prescribed for rheumatologic disorders, including spondyloarthropathies, rheumatoid arthritis, and psoriatic arthritis, x 83 Clegg, D.O., Reda, D.J., and Abdellatif, M. Comparison of sulfasalazine and placebo for the treatment of axial and peripheral articular manifestations of the seronegative spondylarthropathies: a Department of Veterans Affairs cooperative study. Arthritis Rheum . 1999 ; 42 : 2325–2329 | | | , x 84 Clegg, D.O., Reda, D.J

2019 American Gastroenterological Association Institute

96. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities

% of patients evaluated in tertiary care rheumatology centers. Thus, a proactive approach to PsA screening is imperative. Gisondi et al determined the prevalence of PsA in patients hospitalized for cutaneous psoriasis. x 10 Gisondi, P., Girolomoni, G., Sampogna, F., Tabolli, S., and Abeni, D. Prevalence of psoriatic arthritis and joint complaints in a large population of Italian patients hospitalised for psoriasis. Eur J Dermatol . 2005 ; 15 : 279–283 Using the European Spondyloarthropathy Study Group

2019 American Academy of Dermatology

97. Familial Mediterranean fever

. Characterised by recurrent attacks of fever and systemic inflammation, typically lasting 24 to 72 hours and presenting in childhood. Rare manifestations include chronic arthritis, spondyloarthropathy, myopathies, and fibromyalgia. Clinical judgement is important in establishing the diagnosis, which is often made retrospectively. Majority respond to colchicine, which is almost always diagnostic and distinguishes from other inherited periodic fever syndromes. Colchicine is the only proven treatment

2017 BMJ Best Practice

98. In adults with inflammatory arthritis and persistent knee synovitis, does yttrium synovectomy improve pain and function?

synovectomy is usually offered to patients who are perceived to have failed these options and in whom surgery may be the only other consideration. Inclusion Criteria Description Search terms Population and Setting Adults with inflammatory arthritis Excluded: Children monoarthritis (monoarthriti*; rheumatoid arthriti*, psoriatric, spondyloarthropathy Seronegative arthriti* Intervention or Exposure (ie what is being tested) Intervention of yttrium radio- synovectomy Yttrium radiosynoviorthesis Chemical

2017 Public Health England

99. Level of Care for Musculoskeletal Surgery

-and-Notices-Items/CMS- 1678-FC.html?DLPage=1&DLEntries=10&DLSort=2&DLSortDir=descending Copyright © 2018. AIM Specialty Health. All Rights Reserved. Level of Care for Musculoskeletal Surgery and Procedures 8 • Indications that are emergent and/or systemic o Acute trauma with fracture o Spinal neoplasm o Septic arthritis o Complication of inflammatory arthritis / seronegative spondyloarthropathy (SpA) • Prolonged operative or anesthesia time (anticipated > 3 hours) • Revision surgery • Procedure specific o (...) /Hospital-Outpatient-Regulations-and-Notices-Items/CMS- 1678-FC.html?DLPage=1&DLEntries=10&DLSort=2&DLSortDir=descending • Indications that are emergent and/or systemic o Acute trauma with fracture o Spinal neoplasm o Septic arthritis o Complication of inflammatory arthritis / seronegative spondyloarthropathy (SpA) • Prolonged operative or anesthesia time (> 3 hours) • Revision surgery • Surgical facility does not have capability for 23-hour observation or arrangements in place for overnight hospital

2018 AIM Specialty Health

100. Appropriate Use Criteria: Imaging of the Spine

Cervical Spine | Copyright © 2018. AIM Specialty Health. All Rights Reserved. 8 Common Diagnostic Indications Spondyloarthropathies Note: Including but not limited to: ankylosing spondylitis, reactive arthritis, psoriatic arthritis, spondyloarthritis associated with inflammatory bowel disease, juvenile-onset spondyloarthritis ? For diagnosis following non-diagnostic work-up including but not limited to: ? Radiographs ? Standard laboratory work-up for spondyloarthropathy Syringohydromyelia (syrinx (...) ; OR ? With adolescent idiopathic scoliosis and atypical findings (pain, rapid progression, development of neurologic signs/ symptoms); OR ? With scoliosis related to other pathologic processes such as neurofibromatosis; OR ? For pre-operative evaluation of severe scoliosis Significant acute trauma to the cervical spine region Spinal cord infarctMRI Cervical Spine | Copyright © 2018. AIM Specialty Health. All Rights Reserved. 12 Common Diagnostic Indications Spondyloarthropathies ? For diagnosis following non

2018 AIM Specialty Health

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