The Intern At Work: Internal Medicine cover image

The Intern At Work: Internal Medicine

205. Beware of PEAR - An Approach to Seronegative Spondyloarthritides

Sep 3, 2023
This podcast discusses the pathophysiology, clinical presentation, associated diseases, and treatment of seronegative spondyloarthritides. It explores the historical origins of these disorders, the approach to assessing severe peripheral oligoarthritis, the importance of combining clinical and radiological findings for diagnosis, and the goals and options for treatment.
13:56

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Quick takeaways

  • Seronegative spondyloarthritides are a group of inflammatory disorders involving joint inflammation, axial skeleton, and anthocitis, with negative rheumatoid factor and anti-CCP.
  • Assessing for features of inflammatory arthritis, extra-articular manifestations, family history, and functional limitations is crucial when evaluating a patient suspected of seronegative spondyloarthritides.

Deep dives

Overview of seronegative spondyloarthritidies

Seronegative spondyloarthritidies belong to a family of disorders that include ankylosing spondylitis, psoriatic arthritis, enteropathic arthritis, and reactive arthritis. These conditions are characterized by joint inflammation, involvement of the spine or axial skeleton, and the presence of anthocitis. Although patients with seronegative spondyloarthritidies test negative for rheumatoid factor and anti-CCP, they are distinct from those with clinical rheumatoid arthritis. The exact pathophysiology of these conditions is not fully understood, but genetic and environmental factors play a role, and cytokines such as tumor necrosis factor and interleukin-17 are implicated in the inflammatory cascade.

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