Multisystems pathology

Question 1

What is rhomatoid arthritis?

Answer 1

Synovitis is the main feature; synovium becomes swollen and cells proliferate, causing a dense cellular membrane (pannus) spreads over articular cartilage and erodes the underlying cartilage and bone; over time the pannus may extend to the opposite articular surface

Question 2

What does the pannus do to surrounding tissue in RA

Answer 2

1) fibrous scar tissue, 2) adhesions, 3) bony ankylosing; immobility and consolidation (bones form a single unit) of a joint; bones can become osteopenic and ligaments and tendons become damaged or ruptured; surrounding mm deteriorate leaving joint unstable and prone to deformity

Question 3

Criteria for RA:

Answer 3

1. morning stiffness > 1hr (6 weeks),
2. arthritis of >/= 3 joints (6 weeks),
3. arthritis of hand joints,
4. symmetric arthritis (6 weeks),
5. rheumatoid nodules,
6. serum rheumatoid factor,
7. radiographic changes

Question 4

What abnormal antibody do people with RA have

Answer 4

HLA-DR4 in 80% of people with RA

Question 5

Rehab for RA for acute and chronic phase

Answer 5

Acute phase-energy conservation, ice, splints, gentle ROM, NO STRETCHING as it may stretch the synovial membrane and cause irreversible damage.

Chronic phase-relieve pain, i.e. modalities, splints, exercise (gentle ROM), relaxation/rest; reduce stiffness-gentle ROM, aquatic ex, heat; functional ex’s, prevent deformity