DR Medhat MRCP

• Management
Symptomatic: analgesia, NSAIDS, intra-articular steroids
Sulfasalazine and methotrexate are sometimes used for persistent disease
• Prognosis : Symptoms rarely last more than 12 months
Keratoderma blenorrhagica
• Aetiology :
Enteropathic arthropathy
An association with inflammatory bowel disease.
50% are HLA-B27 positive.
Familial aggregation.
Considerable overlap within families; some members having another of the
seronegative spondoarthritides.
• Clinical features :
Presentation is usually acute.
Often migratory, oligo-arthritis of the weight bearing joints which follows
exacerbations of bowel disease.
Other features associated with bowel disease such as
o Apthous ulceration
o Uveitis .
o Erythema nodosum .
• Investigations :
- Investigations may reveal a leucocytosis, raised ESR, raised CRP,
hypergammaglobulinaemia and a negative rheumatoid factor.
- Bowel studies - endoscopy, barium studies - should be undertaken.
• Treatment :
- The underlying bowel disease must be treated.
- NSAID's and physiotherapy may be used to manage the arthritis.
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