Lec 5 RA Flashcards
What are clinical criteria for RA?
- morning stiffness > 30 min
- arthritis of 3 or more joints = polyarthritis
- arthritis of hand joints wrist, MCP, or PIP
- symmetric arthritis
- rheumatoid nodules
- serum RF
What are two diseases in which you see rheumatoid factor even more than in RA?
- sjogrens syndrome
- cryoglobulinemia from chronic hep C
What is appearance of synovial fluid in RA?
- slightly turbid, yellow
- WBCs 5,000-50,000
- 85% polys
- low glucose
- culture negative
What are anti-cyclic citrulinated peptide antibodies?
auto antibody against Ags containing deimated forms of fibrin
less sensitive but more specific than RF for RA; tells you there is an inflammatory arthritis
What is normal age of onset RA?
20s-30s
What is adult stills disease? sign?
type of RA
signs:
poly or oligo arthritis; pericarditis; hepatosplenomegaly; high fever
What is palindromic rheumatism?
period of intense joint swelling then goes away; eventually lengthens and persists
What joints are involved in RA vs OA?
RA = wrists, MCPs, PIPs
OA = DIPs, weight bearing joints
What lab findings in RA?
- increased ESR
- rheumatoid factor
- anti-cyclic citrullinated peptide antibody
- HLA-DR4
- anemia
- leukocytosis
What happens to hands in advanced RA?
subluxation
ulnar deviation of fingers
What is a swan neck deformity?
PIP extended, DIP flexed
What is boutaneers deformity?
PIP flexed, DIP extended
What is baker cyst?
cyts in popliteal fossa in RA –> can look like DVT clinically
What is Felty’s syndrome?
- seropositive RA
- splenomegaly
- neutropenia
What are poor prognostic signs of RA?
- rapid development of erosions
- high RF titer
- rheumatoid nodules
- extra artciular disease
