Mod 3-3 Rheumatoid Arthritis Flashcards
What is Rheumatoid arthritis?
A chronic systemic disease of unknown cause that is primarily seen as a non-infectious inflammatory arthritis of the small joints of hands and feet.
RA affects females __ times ____ than males.
three; more
What is the juvenile form of rheumatoid arthritis?
Still’s disease
Who has the highest incidence rate of RA? What is the peak?
Women between the ages of 20 and 60. Peak being 35 and 45 years of age.
What is the definition of Rheumatoid Arthritis?
A multi-system chronic, relapsing, inflammatory process; most commonly manifest as a severe form of synovitis that sometimes lead to the destruction and ankylosis of affected joints.
What is ankylosis?
abnormal stiffening and immobility of a joint due to fusion of the bones.
What is synovitis?
inflammation of a synovial membrane.
Besides joints, what else can RA affect?
Internal organs
What is synovium?
Inner lining of the articular capsule that surrounds all of the freely moving joints of the body (joints of finger, toe, knee, wrist etc…)
What can uncontrolled and chronic RA lead to?
Severe destruction of joints and bony ankylosis.
What is the etiology of RA?
Cause is unknown, but is thught to be an autoimmune disease.
What percent of patients with RA have a circulating autoantibody called the rheumatoid factor (RF)?
80%
Is it known what triggers the autoimmune reaction and then fosters a remission in RA?
No, it is not known but has been the focus of much research.
RA is a non-infectious disease that may either have a ________ and _________ course or undergo spontaneous ________.
protracted; progressive; remission.
What are some extra-articular structures that are affected by RA?
Skin, respiratory tract, and blood vessels.
how does the disease (RA) progress?
Symmetric involvement of multiple joints progressing proximally toward the trunk until almost every joint in the body is involved.
What joints are primarily affected by RA?
Proximal interphalangeal and metacarpophalangeal articulations.
What are some beginning clinical manifestations?
Malaise, fatigue, non-localized musculoskeletal pain and sometimes a low grade fever.
What comes later in RA?
Joint involvement with local swelling, redness and pain.
When is stiffness more likely?
When arising each morning or following periods of inactivity.
What may develop later with RA?
Deformities may develop such as radial deviation of the wrist and ulnar deviation of the fingers.
RA progresses ________.
insidiously (gradually)
RA usually develops in ___ stages.
4
What is the first stage of RA?
Synovitis - Inflammation followed by an overgrowth of the synovial membrane that lines the joints.
What is the second stage of RA?
Pannus (thickened mass of synovium) destroys cartilage, bone and supporting structures that are in its path.
What is the third stage of RA?
Fibrous ankylosis (abnormal stiffening and immobility of a joint due to fusion of the fibrous tissues) from scarring which occludes the joint space.
What is the fourth stage of RA?
Bony ankylosis that causes a complete fusion of the joint.
What is the result of the stages of RA?
A combination of inflammation and crippling deformities.
What is the oldest of all known diseases?
Rheumatoid arthritis
What are the earliest radiographic findings?
Inflammation and soft tissue swelling surrounding the joints, and osteoporosis adjacent to involved joints and later extending to involve the entire bone.
What does pannus cause in radiographic images?
Small points of destruction to develop at the edge of the joints where articular cartilage is absent. Poorly defined margins requires oblique views or magnification.
What causes ankylosis at the joint space?
Destruction of the articular cartilage, subsequent narrowing of the joint space, and a laying down of bony trabeculae across the narrowed joint space.
*Bones of the wrist joint are the ones most frequently affected by this process.
What is the effect of radiographic technique of RA?
Loss of bone mass due to osteoporosis is easily penetrated causing a destructive affect. Decrease technique.
