Category Archives: uveitis

Are you at risk for the complications due to ankylosing spondylitis? Discover what they are…

Ankylosing spondylitis (AS) is an inflammatory form of arthritis that preferentially attacks the spine.  Many people are under the impression it’s one of the less serious forms of arthritis. Uh-uh.  Unfortunately, it has a number of potential complications associated with it.  These include:

  1. Acute eye inflammation, termed “uveitis”, in one-third of patients.  Symptoms include pain, redness, blurred vision, light sensitivity, and if left untreated, blindness.
  2. Osteoporosis occurring in a significant number of patients.  This is a condition where the bones become brittle and more likely to fracture.
  3. Approximately 10-15% of patients have inflammatory bowel disease such as Crohn’s or ulcerative colitis.
  4. Skin involvement occurs in as many as a quarter of patients.  The most common skin condition is psoriasis.
  5. AS can lead to conduction abnormalities in the heart as well as inflammation of the aorta.
  6. Fibrosis of the lungs can cause restrictive lung disease.
  7. Neurologic complications are due to compression of the spinal cord and can be life-threatening.
  8. Long term ankylosing spondylitis can cause a condition called amyloidosis of the kidneys leading to kidney failure.

Comment: Not such a benign condition is it?

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Psoriatic arthritis… an often-missed diagnosis

Psoriatic arthritis is a distinct disease, different from rheumatoid arthritis and ankylosing spondylitis- another common type of arthritis- but sharing similar features to each. The disability and functional impairment in psoriatic arthritis can be as severe as that occurring from rheumatoid arthritis.psoriatic-arthritis

psoriasis_0Typically, a patient will have had psoriasis for a number of years before the arthritis develops. A small proportion of patient will develop the arthritis concurrently with the skin disease and an even smaller percentage will develop the skin disease after the joint disease.

Psoriatic arthritis may affect most joints in an oligoarticular pattern, meaning a few scattered joints are affected and the joint inflammation does not have the symmetrical pattern seen in rheumatoid arthritis. Enthesitis, which is inflammation of the tendons that attach to bone, is common in psoriatic arthritis. “Sausage digits” – swelling of the fingers and toes so that they look like little sausages is frequent. Nail changes are also common. These include “pitting” nail-pitsand separation of the nail from the nailbed. Some patients will develop carpal tunnel syndrome because of inflammation in the wrist. Inflammation of the eyes is a serious complication, as is involvement of the uveitisaortic valve of the heart.

Joint deformity is frequent and affects 40% of patients with the disease. Psoriatic arthritis has a significant impact on quality of life. The skin disease is a tremendous burden and often leads to depression.

The inflammatory process that causes both the skin disease as well as the joint disease is driven by elevated levels of a substance called tumor necrosis factor, or TNF.

A patient with psoriasis who complains of joint pain, swelling, morning stiffness, and fatigue should raise a high level of suspicion for the diagnosis of psoriatic arthritis.

Laboratory testing will show evidence of inflammation and imaging procedures such as magnetic resonance imaging (MRI) can help confirm the diagnosis.

Treatments that improve the skin disease do not necessarily improve joint symptoms and vice versa.

Treatment goals include symptomatic relief and control of disease progression.

Non-steroidal anti-inflammatory drugs are helpful for relieving some symptoms. However the majority of patients with psoriatic arthritis will require a combination of methotrexate or sulfasalazine and anti-TNF biologic therapy. Anti-TNF therapies have provided a significant advance in the treatment of both the skin as well the joint disease in patients with psoriatic arthritis.

For more information on psoriatic arthritis treatments and other arthritis problems go to:

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