Visceral Disorders- Exam 3- Serology (part 3)

HLA stands for

Human Leukocyte antigen

HLA is present on

All cells, most easily detected on leukocytes

HAL is used as a diagnostic adjunct in certain _______ particularly _______

Rheumatoid disorders

Particularly ankylosing spondylitis

Ankylosing spondylitis has a positive

HLA-B27 test

Myasthenia gravis as a positive HLA

HLA B8 and DR3

Chronic inflammatory disorder, predominately affecting young adult males

Ankylosing spondylitis (AS)

What always effects the SI joints

AS (Ankylosing spondylitis)

What is the most common seronegatvie spondyloarthropathy

Ankylosing spondylitis (AS)

90% of AS has positive

HLA B27

Clinical features of AS

Male

15-35

Sacroiliitis

Limited spinal motion

Limited chest expansion (1" or less)

Lab results of AS

+ HLA B27

+ ESR

-RA

-ANA

Suggest a ________ with any of the inflammatory joint diseases

Rheumatological consultation

Skeletal distribution of AS

SI and spine

Subchondral bone inflammation and resporption

Enthesopathy

Different between degenerative and inflammatory enthesopathies in the heel

When its inflammatory its erosive and ill defined, fluffy looking

When degenerative it sharp edges

Inflammatory enthesopathy on the heel most likely from reactive arthritis

Difference between AS and DISH in the cervical spine

Marginal syndesmophytes are seen with what diseases

AS and enteropathic

Non marginal syndesmophytes are seen with what disease

Psoriatic and reactive

Marginal syndesmophytes vs non marginal syndesmophytes

Positive HLA B27 reasons for Sacroiliitis

AS

Enteropathic

Psoriatic

Reiter`s/Reactive Arhtriits

What is the reasons for sacroliliitis that are negative HLA B27

Hyperparathyroidism (Calcium levels)

Gout (uric acid levels)

DJD

UNILATERAL INFECTION

Trauma

Pregnancy

DISH

OCI

Unilateral sacroiliitis diagnosis and differentials and lab

Possibly infection

HLA B27, CBC, ESR

OCI means

Osteitis condesans ilii

Signs of osteitis condesans ilii on x ray

Lots of sclerosis on iliac side, triangular in shape, typically seen in females

Non marginal syndesmophytes on x ray

Signs of sacrililiitis

Bilateral

Symmetrical

Loss of subchondral bone

Osteoitis (sclerosis)

Joint widening

Dagger sign is seen with

AS

Capsule and interpsinous calcification on AP

Trolley track sign

Fused SI and dagger sign means

Seronegative disease AS

Bamboo vertebrae seen with

Seronegative, most likely AS

AS vs DISH vs DDD

Reactive arthritis from foot and AP spine

Shiny corner sign on laterals is most likely seen with

Seronegative as