Question

Which of these does NOT feature eye manifestations in association with a seronegative arthropathy?

• A. Psoriasis
• B. Rheumatoid arthritis
• C. Reiter's syndrome
• D. Ankylosing spondylitis

Hint:

Rheumatoid arthritis is seropositive, not part of the seronegative arthropathy family.

Answer 1

The Correct Option is B

The seronegative arthropathies are a specific family of joint diseases, negative rheumatoid factor, a strong HLA-B27 link, and a habit of inflaming the eye along with the joints. The question asks which option falls outside this eye and joint pattern.

1. Psoriasis (psoriatic arthritis): A true member of the seronegative family. It can cause uveitis and conjunctivitis, so it fits the pattern.
2. Rheumatoid arthritis: Most patients are rheumatoid factor positive, so this disease is seropositive, not seronegative, and it is not grouped with the spondyloarthropathies at all. Any eye disease it causes, like scleritis or dry eyes, comes from a different immune process, not from being a seronegative arthropathy.
3. Reiter's syndrome: The textbook triad here is arthritis, urethritis, and conjunctivitis or uveitis, so eye involvement is one of its defining features.
4. Ankylosing spondylitis: Strongly linked to acute anterior uveitis, a well known extra joint feature of this disease.

Three of the four, psoriasis, Reiter's syndrome, and ankylosing spondylitis, are genuine seronegative arthropathies with known eye disease. Rheumatoid arthritis is the outlier because it belongs to a different disease category altogether.

Let's summarize:

• Seronegative arthropathies (psoriatic arthritis, reactive arthritis, ankylosing spondylitis) commonly inflame the eye.
• Rheumatoid arthritis is usually seropositive and is not part of this family.

So the answer is rheumatoid arthritis.