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home - Miscellaneous - Rheumatological Disease - Joint Disease Written by Dr Sebastian Zeki

Joint Disease

Bacterial dysentery (esp if Yers-inia and HLA-B27) in 33% Can also occur with parasites: Strongyloides stercoralis, Taenia saginata, Endolimax nana, and Dracunculus medinensis Sacroiliac jointsWristKneeAnkle Commonly involved Antibiotic treatment is effective if begun during the diarrheal phase Reactive arthritis Whipple's disease WristKneeAnkle Commonly involved Joint pain occurs during or prior to systemic infection Sacroiliac joints Tropheryma whippelii ElbowWristKneeAnkle Commonly involved Oligoarticular, asymmetric arthralgia and/or arthritis may develop in 50 % of patients. Behcet's disease Coeliac disease Peripheral in 10 %, axial in 8 %, and combined in 9 %Nonerosive and can be either oligo-or polyar-ticular. Joint symp-toms may precede GI symptoms. Joint symp-toms respond to a gluten free diet WristFinger jointsKneeAnkle Commonly involved Shoulder Raynaud’s also occurs in 30% Intestinal bypass arthritisPolyarthralgia/ arthritis can occur weeks or years following jejunocolic and jejunoileal bypass in 25% of patients (predom females).There is an associated urticarial, vesicular, pustular, macular, or nodular skin eruption. X-ray: Marginal joint erosionsSynovial fluids: neutrophilicSynovial biopsies: show chronic synovi-tis with lymphocytes but without lymphoid follicles.Labs: ANA, RF, and HLA-B27 usually -ve, while immune complexes (and cryoglo-bulins) are present.Treatment:1: NSAIDs and glucocorticoids 2: Tetracycline therapy to decrease bacteria overgrowth. Rheumatological Manifestations of Gastrointestinal Disease Written by Dr Sebastian Zeki

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