Autoimmune Diseases

Question 1

Rheumatoid Arthritis

Answer 1

Chronic, systemic autoimmune disease; inflammation of connective tissue in diarthrodial (synovial) joints

• periods of remission and exacerbation
• extraarticular manifestations
• disabling form of arthritis causing loss of independence and self-care
• mobility aids or joint reconstruction may be needed if treatment inadequate

Question 2

RA: who is at risk?

Answer 2

Affects all ethnic groups
Incidence increases with age, peaks between ages 30 and 50
Affect approximately 0.24 to 1 percent of the population
Three times as many women as men

Question 3

Etiology & Pathophysiology

Answer 3

Autoimmune etiology: combination of genetics and environmental triggers
Antigen triggers formation of abnormal IgG
Autoantibodies develop against the abnormal IgG (Rheumatoid Factor)
RF combines with IgG to form immune complexes that deposit on synovial membranes or cartilage in joints; this leads to activation of complement and inflammatory response
Neutrophils release preteolytic enzymes that damage cartilage and thicken synovial lining (immune response)

Question 4

Signs & Symptoms

Answer 4

Onset typically subtle
Fatigue, anorexia, weight loss, generalized stiffness that becomes localized stiffness with progression
May report history of precipitating stressful event:
- infection, stress, exertion, childbirth, surgery, emotional upset

Question 5

Joint Damage

Answer 5

Specific joint involvement
Symmetrical pain, stiffness, limited movement
Often affects small joints
Larger joints and cervical spine may be involved

Question 6

Damage to joint tissues

Answer 6

Joint stiffness after inactivity
MORNING STIFFNESS 60 MINUTES TO SEVERAL HOURS OR LONGER
Fingers spindle shaped
Subluxation: muscle atrophy and tendon destruction
Joint tender, painful, warm to touch
Pain increases with motion, intensity varies