SERONEGATIVE SPONDARTHRITISSERONEGATIVE SPONDARTHRITIS

●● Ankylosing spondylitisAnkylosing spondylitis

●● PsoriasisPsoriasis

● ● Reactive arthritisReactive arthritis

●● Reiters diseaseReiters disease

●● Ulcerative colitisUlcerative colitis

●● Crohn’s diseaseCrohn’s disease

●● (Whipple’s disease) (Whipple’s disease)

CHARACTERISTIC OF SERONEGATIVE CHARACTERISTIC OF SERONEGATIVE SPONDARTHRITIDESSPONDARTHRITIDES

Absence of rheumatoidAbsence of rheumatoid Familial clusteringFamilial clustering

factorfactor Increased incidenceIncreased incidence

Involvement of sacro-Involvement of sacro- of HLA-B27 of HLA-B27

iliac and spinal jointsiliac and spinal joints Common spectrum Common spectrum

Peripheral arthritisPeripheral arthritis of extra-articular of extra-articular

(predominantly(predominantly features (pre- features (pre-

lower limb)lower limb) dominantly muco- dominantly muco-

EnthesopathyEnthesopathy cutaneous) cutaneous)

PATTERNS OF PSORIATIC ARTHROPATHY

Distal interphalangeal joint disease with associated nail lesions.

Seronegative polyarthritis often variable and assymetrical, may develop transient ‘sausage digits’.

Deforming arthritis (‘arthritis mutilans’) Spondylitis

FEATURES OF REITERS DISEASEFEATURES OF REITERS DISEASE●● UrethritisUrethritis●● ConjunctivitisConjunctivitis●● ArthritisArthritis●● EnthesopathyEnthesopathy●● SacroiliitisSacroiliitis●● Keratoderma blenorrhagicaKeratoderma blenorrhagica●● Mouth ulcersMouth ulcers●● Circinate balanitisCircinate balanitis●● CervicitisCervicitis●● IritisIritis

FEATURES OF WHIPPLE’S DISEASEFEATURES OF WHIPPLE’S DISEASE

●● MalabsorptionMalabsorption

●● ArthritisArthritis

●● FeverFever

●● LymphadenopathyLymphadenopathy