6.2. Rheumatology - Clinical Aspects Flashcards
What is Rheumatoid Arthritis?
A Chronic Auto-Immune Systemic Illmess, characterised by Symmetrical Peripheral Arthritis and other Systemic Features
How common is Rheumatoid Arthritis?
Very Common - Approximately 1% of the Population
What is Rheumatoid Arthritis associated with?
- Joint Damage
- Disability
- Premature Mortality
Which sex is Rheumatoid Arthritis more common in?
Female (3:1)
What is the peak age of onset for Rheumatoid Arthritis?
4th/5th Decade
Note - This may occur from any age after 16
What are the Aetiological Factors of Rheumatoid Arthritis?
- Genetic
2. Environmental
What is the Genetic Contribution to Rheumatoid Arthritis estimated to be?
50-60%
What are the Major Emvironmental Factors contributing to Rheumatoid Arthritis?
- Cigarette Smoking
2. Chronic Infection (Periodontal infection)
What is the Classification Criteria for Rheumatoid Arthritis?
- Joint Involvement (Number of Large / Small)
- Serology (+ve RF or ACPA)
- Acute Phase Reactants (CRP and ESR)
- Duration of Symptoms (> 6 weeks)
What are the symptoms of Rheumatoid Arthritis?
- Pain, Stiffness, Immobility
- Poor Function
- Systemic Symptoms
What are the Clinical Signs of Rheumatoid Arthritis?
- Swelling, Tenderness, Redness and heat
2. Limitation of Movement
What Clinical Systemic Features occur with Rheumatoid Arthritis?
- Non-Specific:
- a) Fatigue / Lassitude
- b) Weight Loss
- c) Anaemia
- Specific: Eyes / Lungs / Nerves / Skin / Kidneys
- Long-Term: CVS / Malignancy
What immunological investigations are used in Rheumatoid Arthritis?
- Anti-Cyclic Citrullinated Antibodies (Anti-CCP, ACPA)
2. Rheumatoid Factor (IgG, IgM)
What is the outcome of Rheumatoid Arthritis?
- 75% of cases are diagnosed during working life
- About 33% will stopped working within 2 years
- About 50% will be unable to work within 10 years
- Someone with this will have 40 days sick leave/year
