SlideShare ist ein Scribd-Unternehmen logo
1 von 28
2011 Juvenile Arthritis Conference Bob Colbert MD, PhD Senior Investigator Chief, Pediatric Translational Research Branch NIAMS/NIH Juvenile Spondyloarthritis and Psoriatic Arthritis
Disclosures: ,[object Object]
Objectives: ,[object Object]
What is Spondyloarthritis? What is Psoriatic Arthritis? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is Spondyloarthritis?
Sacroiliac Joints
Dactylitis
Psoriatic Skin Rash
Psoriatic Nail Changes
Eye Inflammation (Acute Anterior Uveitis) ,[object Object],[object Object],[object Object],[object Object],[object Object]
How are JSpA and JPsA diagnosed ? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
JIA Subtypes Few Joints (less than 5) = Oligoarticular Many Joints (5 or more) =  Polyarticular Fever/rash = Systemic SpA (spine) = ERA With Psoriasis = PsA ?
Juvenile Spondyloarthritis (Enthesitis-Related Arthritis) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Juvenile Psoriatic Arthritis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Two Subgroups of JPsA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How common is juvenile arthritis ? ,[object Object],[object Object],[object Object],Lawrence RA,  et al. ,  Arth Rheum  1998; 41:778-799 Sacks J  et al .,  Arth Rheum  2007; 57:1439-1455
How do we treat JIA ?
Management of JIA ,[object Object],[object Object],[object Object],[object Object]
Treatment  Pyramid NSAIDS, PT/OT GLUCOCORTICOIDS Methotrexate, Corticosteroid injections Biologics (anti-TNF, anti-IL-1, anti-IL-6) EXP
Management of JIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Biologics Frequently Used in Juvenile Arthritis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Biologics Frequently Used in Juvenile Arthritis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why is it important to do research in children ? To practice evidence-based medicine If we don’t do research, every treatment becomes a poorly controlled experiment
Observational Studies ,[object Object],[object Object],[object Object],[object Object],[object Object]
Translational Studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spondyloarthritis
Thank you for your attention! National Institute of Arthritis and Musculoskeletal and Skin Diseases
 

Weitere ähnliche Inhalte

Was ist angesagt?

Approach arthritis in childhood
Approach arthritis in childhoodApproach arthritis in childhood
Approach arthritis in childhoodSingaram_Paed
 
Juvenile idiopathic arthritis
Juvenile idiopathic arthritisJuvenile idiopathic arthritis
Juvenile idiopathic arthritisAriyanto Harsono
 
Approach to a child with arthritis by dr praman kushwah
Approach to a child with arthritis by dr praman kushwahApproach to a child with arthritis by dr praman kushwah
Approach to a child with arthritis by dr praman kushwahDr Praman Kushwah
 
juvelnile idiopathic arthritis
juvelnile idiopathic arthritisjuvelnile idiopathic arthritis
juvelnile idiopathic arthritisAshik Alvee
 
Juvenile rheumatoid arthritis
Juvenile rheumatoid arthritisJuvenile rheumatoid arthritis
Juvenile rheumatoid arthritisAzi YueDee
 
A case presentation on juvenile idiopathic arthritis
A case presentation on juvenile idiopathic arthritisA case presentation on juvenile idiopathic arthritis
A case presentation on juvenile idiopathic arthritisDr. Tanvir
 
Juvenile Idiopathic Arthritis
Juvenile Idiopathic ArthritisJuvenile Idiopathic Arthritis
Juvenile Idiopathic ArthritisNihal Yuzbasheva
 
Juvenile idiopathic arthritis
Juvenile idiopathic arthritisJuvenile idiopathic arthritis
Juvenile idiopathic arthritisDR RML DELHI
 
Approach To A Patient With Polyarthritis
Approach To A Patient With PolyarthritisApproach To A Patient With Polyarthritis
Approach To A Patient With PolyarthritisPramod Mahender
 
Dr shridhar jia children and young people with arthritis.ppt 121011
Dr shridhar jia children and young people with arthritis.ppt 121011Dr shridhar jia children and young people with arthritis.ppt 121011
Dr shridhar jia children and young people with arthritis.ppt 121011milanb1
 
Inflammatory arthritis
Inflammatory arthritisInflammatory arthritis
Inflammatory arthritisMike Aref
 
Approach to a child with monoarthritis
Approach to a child with monoarthritisApproach to a child with monoarthritis
Approach to a child with monoarthritisRaghavendra Babu
 
JIA clinical practice guidelines
JIA clinical practice guidelinesJIA clinical practice guidelines
JIA clinical practice guidelinesjuliann trumpower
 

Was ist angesagt? (20)

Reactive arthritis
Reactive arthritisReactive arthritis
Reactive arthritis
 
Approach arthritis in childhood
Approach arthritis in childhoodApproach arthritis in childhood
Approach arthritis in childhood
 
Juvenile Idiopathic Arthritis
Juvenile Idiopathic ArthritisJuvenile Idiopathic Arthritis
Juvenile Idiopathic Arthritis
 
Juvenile idiopathic arthritis
Juvenile idiopathic arthritisJuvenile idiopathic arthritis
Juvenile idiopathic arthritis
 
Approach to a child with arthritis by dr praman kushwah
Approach to a child with arthritis by dr praman kushwahApproach to a child with arthritis by dr praman kushwah
Approach to a child with arthritis by dr praman kushwah
 
Approach to arhritis in children
Approach to arhritis in childrenApproach to arhritis in children
Approach to arhritis in children
 
Inflammatory arthritis an overview
Inflammatory arthritis an overviewInflammatory arthritis an overview
Inflammatory arthritis an overview
 
juvelnile idiopathic arthritis
juvelnile idiopathic arthritisjuvelnile idiopathic arthritis
juvelnile idiopathic arthritis
 
Juvenile rheumatoid arthritis
Juvenile rheumatoid arthritisJuvenile rheumatoid arthritis
Juvenile rheumatoid arthritis
 
A case presentation on juvenile idiopathic arthritis
A case presentation on juvenile idiopathic arthritisA case presentation on juvenile idiopathic arthritis
A case presentation on juvenile idiopathic arthritis
 
Juvenile Idiopathic Arthritis
Juvenile Idiopathic ArthritisJuvenile Idiopathic Arthritis
Juvenile Idiopathic Arthritis
 
Juvenile idiopathic arthritis
Juvenile idiopathic arthritisJuvenile idiopathic arthritis
Juvenile idiopathic arthritis
 
Approach To A Patient With Polyarthritis
Approach To A Patient With PolyarthritisApproach To A Patient With Polyarthritis
Approach To A Patient With Polyarthritis
 
Dr shridhar jia children and young people with arthritis.ppt 121011
Dr shridhar jia children and young people with arthritis.ppt 121011Dr shridhar jia children and young people with arthritis.ppt 121011
Dr shridhar jia children and young people with arthritis.ppt 121011
 
Inflammatory arthritis
Inflammatory arthritisInflammatory arthritis
Inflammatory arthritis
 
Approach to Arthritis in Children
Approach to Arthritis in ChildrenApproach to Arthritis in Children
Approach to Arthritis in Children
 
Inflammatory arthritis
Inflammatory arthritisInflammatory arthritis
Inflammatory arthritis
 
Approach to a child with monoarthritis
Approach to a child with monoarthritisApproach to a child with monoarthritis
Approach to a child with monoarthritis
 
Juvenile ra
Juvenile raJuvenile ra
Juvenile ra
 
JIA clinical practice guidelines
JIA clinical practice guidelinesJIA clinical practice guidelines
JIA clinical practice guidelines
 

Ähnlich wie What is Spondyloarthritis? What is Psoriatic Arthritis?

Dr shridhar jia children and young people with arthritis.ppt
Dr shridhar jia children and young people with arthritis.pptDr shridhar jia children and young people with arthritis.ppt
Dr shridhar jia children and young people with arthritis.pptmilanb1
 
Dr shridhar jia children and young people with arthritis.ppt 121011
Dr shridhar jia children and young people with arthritis.ppt 121011Dr shridhar jia children and young people with arthritis.ppt 121011
Dr shridhar jia children and young people with arthritis.ppt 121011milanb1
 
Dr shridhar jia children and young people with arthritis
Dr shridhar jia children and young people with arthritisDr shridhar jia children and young people with arthritis
Dr shridhar jia children and young people with arthritismilanb1
 
My Knee Hurts! A Look at Joint Pain in Children - Marla Guzman, MD - 1.12.2021
My Knee Hurts! A Look at Joint Pain in Children - Marla Guzman, MD - 1.12.2021My Knee Hurts! A Look at Joint Pain in Children - Marla Guzman, MD - 1.12.2021
My Knee Hurts! A Look at Joint Pain in Children - Marla Guzman, MD - 1.12.2021Summit Health
 
Juvenile idiopathic arthritis
Juvenile idiopathic arthritisJuvenile idiopathic arthritis
Juvenile idiopathic arthritiszohrer
 
Limping child medicine collage. (7).pdf
Limping child medicine collage.  (7).pdfLimping child medicine collage.  (7).pdf
Limping child medicine collage. (7).pdfBaraagaoud
 
JuvenineI Idiopatic document for MSc.pptx
JuvenineI Idiopatic document for MSc.pptxJuvenineI Idiopatic document for MSc.pptx
JuvenineI Idiopatic document for MSc.pptxMitikuTeka1
 
Juvenile idiopathic arthritis (JIA)
Juvenile idiopathic arthritis (JIA) Juvenile idiopathic arthritis (JIA)
Juvenile idiopathic arthritis (JIA) ramarawand
 
Juvenile arthritis an overview
Juvenile arthritis an overviewJuvenile arthritis an overview
Juvenile arthritis an overviewNilesh Jadhav
 
419807346-Juvenile-Idiopathic-Arthritis.pptx
419807346-Juvenile-Idiopathic-Arthritis.pptx419807346-Juvenile-Idiopathic-Arthritis.pptx
419807346-Juvenile-Idiopathic-Arthritis.pptxendahrahmadani1
 
Juvenile idiopathic arthritis (JIA)
Juvenile idiopathic arthritis (JIA)Juvenile idiopathic arthritis (JIA)
Juvenile idiopathic arthritis (JIA)yuyuricci
 
Juvenile_Idiopathic_Arthritis.pptx
Juvenile_Idiopathic_Arthritis.pptxJuvenile_Idiopathic_Arthritis.pptx
Juvenile_Idiopathic_Arthritis.pptxazzaelnenaey
 
Pediatric Arthritis Syndromes
Pediatric Arthritis SyndromesPediatric Arthritis Syndromes
Pediatric Arthritis Syndromesaburiziza
 
Adalimumab_Launch.ppt
Adalimumab_Launch.pptAdalimumab_Launch.ppt
Adalimumab_Launch.pptssuser4c6ee1
 
Rheumatology update final
Rheumatology update finalRheumatology update final
Rheumatology update finaljamesandshantha
 
Juvenile+Rheumatoid+Arthritis+slides
Juvenile+Rheumatoid+Arthritis+slidesJuvenile+Rheumatoid+Arthritis+slides
Juvenile+Rheumatoid+Arthritis+slidesdhavalshah4424
 

Ähnlich wie What is Spondyloarthritis? What is Psoriatic Arthritis? (20)

Dr shridhar jia children and young people with arthritis.ppt
Dr shridhar jia children and young people with arthritis.pptDr shridhar jia children and young people with arthritis.ppt
Dr shridhar jia children and young people with arthritis.ppt
 
Dr shridhar jia children and young people with arthritis.ppt 121011
Dr shridhar jia children and young people with arthritis.ppt 121011Dr shridhar jia children and young people with arthritis.ppt 121011
Dr shridhar jia children and young people with arthritis.ppt 121011
 
Dr shridhar jia children and young people with arthritis
Dr shridhar jia children and young people with arthritisDr shridhar jia children and young people with arthritis
Dr shridhar jia children and young people with arthritis
 
JIA 101: Welcome to the Club
JIA 101: Welcome to the ClubJIA 101: Welcome to the Club
JIA 101: Welcome to the Club
 
My Knee Hurts! A Look at Joint Pain in Children - Marla Guzman, MD - 1.12.2021
My Knee Hurts! A Look at Joint Pain in Children - Marla Guzman, MD - 1.12.2021My Knee Hurts! A Look at Joint Pain in Children - Marla Guzman, MD - 1.12.2021
My Knee Hurts! A Look at Joint Pain in Children - Marla Guzman, MD - 1.12.2021
 
Juvenile idiopathic arthritis
Juvenile idiopathic arthritisJuvenile idiopathic arthritis
Juvenile idiopathic arthritis
 
Limping child medicine collage. (7).pdf
Limping child medicine collage.  (7).pdfLimping child medicine collage.  (7).pdf
Limping child medicine collage. (7).pdf
 
Arthritis
ArthritisArthritis
Arthritis
 
JuvenineI Idiopatic document for MSc.pptx
JuvenineI Idiopatic document for MSc.pptxJuvenineI Idiopatic document for MSc.pptx
JuvenineI Idiopatic document for MSc.pptx
 
Juvenile idiopathic arthritis (JIA)
Juvenile idiopathic arthritis (JIA) Juvenile idiopathic arthritis (JIA)
Juvenile idiopathic arthritis (JIA)
 
Juvenile arthritis an overview
Juvenile arthritis an overviewJuvenile arthritis an overview
Juvenile arthritis an overview
 
419807346-Juvenile-Idiopathic-Arthritis.pptx
419807346-Juvenile-Idiopathic-Arthritis.pptx419807346-Juvenile-Idiopathic-Arthritis.pptx
419807346-Juvenile-Idiopathic-Arthritis.pptx
 
Juvenile idiopathic arthritis (JIA)
Juvenile idiopathic arthritis (JIA)Juvenile idiopathic arthritis (JIA)
Juvenile idiopathic arthritis (JIA)
 
Juvenile_Idiopathic_Arthritis.pptx
Juvenile_Idiopathic_Arthritis.pptxJuvenile_Idiopathic_Arthritis.pptx
Juvenile_Idiopathic_Arthritis.pptx
 
Suppurative Arthritis
Suppurative ArthritisSuppurative Arthritis
Suppurative Arthritis
 
Pediatric Arthritis Syndromes
Pediatric Arthritis SyndromesPediatric Arthritis Syndromes
Pediatric Arthritis Syndromes
 
Adalimumab_Launch.ppt
Adalimumab_Launch.pptAdalimumab_Launch.ppt
Adalimumab_Launch.ppt
 
Rheumatology update final
Rheumatology update finalRheumatology update final
Rheumatology update final
 
JUVENILE_PSORIATIC_ARTHRITIS.ppt
JUVENILE_PSORIATIC_ARTHRITIS.pptJUVENILE_PSORIATIC_ARTHRITIS.ppt
JUVENILE_PSORIATIC_ARTHRITIS.ppt
 
Juvenile+Rheumatoid+Arthritis+slides
Juvenile+Rheumatoid+Arthritis+slidesJuvenile+Rheumatoid+Arthritis+slides
Juvenile+Rheumatoid+Arthritis+slides
 

Mehr von 2011 Juvenile Arthritis Conference

Mehr von 2011 Juvenile Arthritis Conference (15)

Getting Past Gridlock
Getting Past GridlockGetting Past Gridlock
Getting Past Gridlock
 
Lost? Finding Your Medical Home!
Lost? Finding Your Medical Home!Lost? Finding Your Medical Home!
Lost? Finding Your Medical Home!
 
Exercise: To Rest is To Rust
Exercise: To Rest is To RustExercise: To Rest is To Rust
Exercise: To Rest is To Rust
 
Pain! Why & What To Do About It
Pain! Why & What To Do About ItPain! Why & What To Do About It
Pain! Why & What To Do About It
 
Segal North American Osteoarthritis Worshop
Segal North American Osteoarthritis WorshopSegal North American Osteoarthritis Worshop
Segal North American Osteoarthritis Worshop
 
Get into the Research
Get into the ResearchGet into the Research
Get into the Research
 
Understanding the Osteoarthritis Consumer
Understanding the Osteoarthritis ConsumerUnderstanding the Osteoarthritis Consumer
Understanding the Osteoarthritis Consumer
 
Resilient Family, Resilient Kid
Resilient Family, Resilient KidResilient Family, Resilient Kid
Resilient Family, Resilient Kid
 
Genetics: A Piece of the Puzzle
Genetics: A Piece of the PuzzleGenetics: A Piece of the Puzzle
Genetics: A Piece of the Puzzle
 
Transition to Independence
Transition to IndependenceTransition to Independence
Transition to Independence
 
MYTHS vs. FACTS
MYTHS vs. FACTSMYTHS vs. FACTS
MYTHS vs. FACTS
 
Other Pediatric Rheumatic DIseases
Other Pediatric Rheumatic DIseasesOther Pediatric Rheumatic DIseases
Other Pediatric Rheumatic DIseases
 
What to Look for in a Job and How to Get It
What to Look for in a Job and How to Get ItWhat to Look for in a Job and How to Get It
What to Look for in a Job and How to Get It
 
Dancing: Alternative Therapies
Dancing: Alternative TherapiesDancing: Alternative Therapies
Dancing: Alternative Therapies
 
Improving Access to Pediatric Subspecialty Care
Improving Access to Pediatric Subspecialty CareImproving Access to Pediatric Subspecialty Care
Improving Access to Pediatric Subspecialty Care
 

Kürzlich hochgeladen

Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Anamika Rawat
 
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service AvailableCall Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service AvailableJanvi Singh
 
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...GENUINE ESCORT AGENCY
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...chandars293
 
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Sheetaleventcompany
 
Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...
Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...
Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...Anamika Rawat
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...adilkhan87451
 
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadGENUINE ESCORT AGENCY
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...khalifaescort01
 
Top Rated Pune Call Girls (DIPAL) ⟟ 8250077686 ⟟ Call Me For Genuine Sex Serv...
Top Rated Pune Call Girls (DIPAL) ⟟ 8250077686 ⟟ Call Me For Genuine Sex Serv...Top Rated Pune Call Girls (DIPAL) ⟟ 8250077686 ⟟ Call Me For Genuine Sex Serv...
Top Rated Pune Call Girls (DIPAL) ⟟ 8250077686 ⟟ Call Me For Genuine Sex Serv...Dipal Arora
 
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Namrata Singh
 
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...BhumiSaxena1
 
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...parulsinha
 
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappMost Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappInaaya Sharma
 
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Sheetaleventcompany
 
Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510Vipesco
 
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...parulsinha
 
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426jennyeacort
 

Kürzlich hochgeladen (20)

Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
 
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
 
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service AvailableCall Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
 
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
 
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
 
Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...
Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...
Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
 
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
 
Top Rated Pune Call Girls (DIPAL) ⟟ 8250077686 ⟟ Call Me For Genuine Sex Serv...
Top Rated Pune Call Girls (DIPAL) ⟟ 8250077686 ⟟ Call Me For Genuine Sex Serv...Top Rated Pune Call Girls (DIPAL) ⟟ 8250077686 ⟟ Call Me For Genuine Sex Serv...
Top Rated Pune Call Girls (DIPAL) ⟟ 8250077686 ⟟ Call Me For Genuine Sex Serv...
 
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
 
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
 
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
 
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
 
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappMost Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
 
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
 
Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510
 
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
 
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
 

What is Spondyloarthritis? What is Psoriatic Arthritis?