Commonly Associated Medical Syndromes

Abstract

Rheumatologic diseases such as RA, ankylosing spondylitis, psoriatic arthritis, SLR, and osteogenesis imperfecta make up a large percentage of pathologies in patients undergoing orthopedic surgery. These arthropathies are progressive, difficult to treat, and often lead to lifelong debilitating pain and disability. In addition to their effects on bones and joints, they are all characterized as medical syndromes, which affect many other organs and tissues throughout the body. Subsequently, these patients often have many comorbidities that make rendering a safe anesthetic challenging. Disease-modifying therapy combines aggressive immunomodulatory agents and immunosuppression. Severe joint destruction is treated surgically, but these surgeries are often at increased risk due to the effects of these syndromes on other organ systems. In this review, we address the approach to and evaluation of these five commonly associated medical syndromes and their medical and/or surgical treatment as well as any anesthetic considerations. This review 5 figures, 4 tables, and 50 references.  Key Words: anesthetic considerations, ankylosing spondylitis, inflammatory arthropathies, psoriatic arthritis, orthopedics, osteogenesis imperfecta, rheumatoid arthritis, rheumatologic syndromes, systemic lupus erythematosus