Arthritis mulitans: very destructive: bone starts to be eaten away.
Subcutaneous nodules not present (in 20-30% of RA patients: can look at this, but the absence doesn\u2019t rule out RA)
\u00bc of patients have + rheumatoid factor
Primary symptom: \u00bd have spondylitis and \u00bd have sacroiliitis
Not as bad as AS
Small percentage develop arthritis mutilans
Ensethopathy: irritation to soft tissue components that attach to bone.
Skin is what we show the world. What isn\u2019t meshing with a patient with a skin pathology?
Skin pathologies: always irritating patient, always in their face.
Combination of 3 different paths in one. Arthritis, UTI, eye inflammation (conjunctivitis). \u201cCan\u2019t see, can\u2019t pee, can\u2019t dance
Look at patient\u2019s history. Sexual practices? Travel to location where they may have contracted dysentery.l
Dr. Loken had a patient with arthritic symptoms, but his main concern was that he was developing so many floaters that he was losing peripheral vision and general vision. Patient convinced that he had STI. Had no partners before 20 year marriage, his wife had no partners. Why does he think he had an STI?
Talk with patient, look at history, there were blanked out areas in his memory. Skipped age 9-16. Had blocked out
this part of his life. Had been molested by his older brother when he was about 10. From this incident, thought that
he had an STI. He thought he would get an STI from ANY anal sex: not just with an infected person. Decided that he
needed to talk to his brother. Second appointment, felt 50% better. Didn\u2019t see patient again.
Correlation between IBS and the onset of AS.
Will start to get inflammation in SI joint: this may be the first thing that they notice.
Spine will fuse over time. Will lock, and will havev to use muscles to keep themselves upright.
Spine becomes rigid: bamboo spine
Youngest of arthritides: 15-35 years old. White male disease.
90% have HLA-B27
Main symptom is bilateral sacroiliitis.
Will have limited expansion through ribs.
Affects CV and lungs: chest isn\u2019t expanding the way that it is supposed to. Pressure systems that rely on the space that
they have for proper functioning.
Getting frozen in your body. Can\u2019t move into next phase of life? High school, college time frame. Lots of change in this
SI joint is a transition between earth and water.
What is PARALYZING them from moving forward? Fear?
Now bringing you back...
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