clinical aspects of RA Flashcards
synovitis
inflammation around synovial membrane, leading to hypertrophy of membrane, inflammation and damage to surrounding structures
RA investigations
clinical assessment: Hx and exam
immunology: ACPA
x-ray
USS
symptoms RA
pain
stiffness
immobolity/poor mobility
poor function
signs of RA
swelling tenderness limitation movement redness heat
RA vs other types arthritis
RA multiple joints
RA symmetrical
RA peripheral joints - hands and feet
systemic features of RA
non-specific: fatigue, weight loss, anaemia
specific: eyes, lungs, nerves, skin, kidneys
longterm: CVS, malignancy
RA assessment socre
disease activity score: DAS 28
DAS > 2.4
represents clinical remission
DAS > 5.1
represents eligibility for biological therapy
felty’s syndrome features and management
extra-articular manifestation RA
neutropenia + splenomegaly
rx = methotrexate
RA x-ray findings
SPADES
soft tissue swelling peri-articular osteoporosis deformity erosions subluxation
RA examination findings
soft tissue swelling rhuematoid nodules wasting small. muscles hand ulnar deviation of fingers boutonniere deformity swan neck deformity bone erosions joint subluxation or complete carpal tunnel syndrome
extra-articular features RA
vasculitic rash rheumatic nodules pericardial effusions nephrotic syndrome amyloidosis splenomegaly lymphadenopathy pulmonary fibrosis
