Mod 3-3 Rheumatoid Arthritis

Question 1

What is Rheumatoid arthritis?

Answer 1

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.

Question 2

RA affects females __ times ____ than males.

Answer 2

three; more

Question 3

What is the juvenile form of rheumatoid arthritis?

Answer 3

Still’s disease

Question 4

Who has the highest incidence rate of RA? What is the peak?

Answer 4

Women between the ages of 20 and 60. Peak being 35 and 45 years of age.

Question 5

What is the definition of Rheumatoid Arthritis?

Answer 5

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.

Question 6

What is ankylosis?

Answer 6

abnormal stiffening and immobility of a joint due to fusion of the bones.

Question 7

What is synovitis?

Answer 7

inflammation of a synovial membrane.

Question 8

Besides joints, what else can RA affect?

Answer 8

Internal organs

Question 9

What is synovium?

Answer 9

Inner lining of the articular capsule that surrounds all of the freely moving joints of the body (joints of finger, toe, knee, wrist etc…)

Question 10

What can uncontrolled and chronic RA lead to?

Answer 10

Severe destruction of joints and bony ankylosis.

Question 11

What is the etiology of RA?

Answer 11

Cause is unknown, but is thught to be an autoimmune disease.

Question 12

What percent of patients with RA have a circulating autoantibody called the rheumatoid factor (RF)?

Answer 12

80%

Question 13

Is it known what triggers the autoimmune reaction and then fosters a remission in RA?

Answer 13

No, it is not known but has been the focus of much research.

Question 14

RA is a non-infectious disease that may either have a ________ and _________ course or undergo spontaneous ________.

Answer 14

protracted; progressive; remission.

Question 15

What are some extra-articular structures that are affected by RA?

Answer 15

Skin, respiratory tract, and blood vessels.

Question 16

how does the disease (RA) progress?

Answer 16

Symmetric involvement of multiple joints progressing proximally toward the trunk until almost every joint in the body is involved.

Question 17

What joints are primarily affected by RA?

Answer 17

Proximal interphalangeal and metacarpophalangeal articulations.

Question 18

What are some beginning clinical manifestations?

Answer 18

Malaise, fatigue, non-localized musculoskeletal pain and sometimes a low grade fever.

Question 19

What comes later in RA?

Answer 19

Joint involvement with local swelling, redness and pain.

Question 20

When is stiffness more likely?

Answer 20

When arising each morning or following periods of inactivity.

Question 21

What may develop later with RA?

Answer 21

Deformities may develop such as radial deviation of the wrist and ulnar deviation of the fingers.

Question 22

RA progresses ________.

Answer 22

insidiously (gradually)

Question 23

RA usually develops in ___ stages.

Answer 23

4

Question 24

What is the first stage of RA?

Answer 24

Synovitis - Inflammation followed by an overgrowth of the synovial membrane that lines the joints.

Question 25

What is the second stage of RA?

Answer 25

Pannus (thickened mass of synovium) destroys cartilage, bone and supporting structures that are in its path.

Question 26

What is the third stage of RA?

Answer 26

Fibrous ankylosis (abnormal stiffening and immobility of a joint due to fusion of the fibrous tissues) from scarring which occludes the joint space.

Question 27

What is the fourth stage of RA?

Answer 27

Bony ankylosis that causes a complete fusion of the joint.

Question 28

What is the result of the stages of RA?

Answer 28

A combination of inflammation and crippling deformities.

Question 29

What is the oldest of all known diseases?

Answer 29

Rheumatoid arthritis

Question 30

What are the earliest radiographic findings?

Answer 30

Inflammation and soft tissue swelling surrounding the joints, and osteoporosis adjacent to involved joints and later extending to involve the entire bone.

Question 31

What does pannus cause in radiographic images?

Answer 31

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.

Question 32

What causes ankylosis at the joint space?

Answer 32

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.

Question 33

What is the effect of radiographic technique of RA?

Answer 33

Loss of bone mass due to osteoporosis is easily penetrated causing a destructive affect. Decrease technique.