sero-negative (sero -ve) arthritis

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sero-negative (sero -ve) arthritis

arthritides not characterized by expression of specific immune-related plasma proteins, although other markers of inflammation will be present (e.g. raised erythrocyte sedimentation rate, C-reactive protein); (see Table 1)
Table 1: Common features of the range of types of sero-negative inflammatory arthritis
FeatureComment
Leukocyte antigen type90% of patients with sero-negative arthritis test positive for human leukocyte antigen (HLA) B27
Skeletal involvementAxial skeleton/spinal involvement; with back pain (common presenting first symptom)
EnthesopathyInflammation at insertions of ligaments/tendons (posterior calcaneum, plantar calcaneum, base of fifth metatarsal, forefoot)
Soft-tissue swellingsLocalized swelling at Achilles tendon insertion
Bursitis of congenital/adventitious bursae
SynovitisDactylitis/'sausage' toe
Generalized swelling of fore foot
VasculitisNote: Does not tend to affect foot in sero-negative arthritides
RadiographsBone/periosteal fluffy/'whiskery' proliferation
New bone/spur formation at entheses, secondary to inflammation