RA Flashcards
what is RA?
-a chronic autoimmune joint disease that causes pain, stiffness etc (in multiple joints in the body)
-body produces ABs that affect the synovial tissue in symmetrical joints (both sides)
describe the aetiology of RA
-2nd most common type of arthritis
-mostly female
-affects 1-3/100 people in Ireland
-can affect all ages
-family history of RA may be present
what small joints does RA affect?
small joints of hands and feet
briefly describe the pathophysiology of RA
-autoimmune
-body produces antibodies that cause a dysregulated inflam process in the synovial of the joint
-over time, this leads to loss of cartilage and bony elements of the joint
describe examples of non genetic risks that could lead to the development of RA
-environmental triggers eg dust
-lifestyle eg smoking
-pregnancy
-infection
-obesity (increased mechanical load on joints & increases inflammatory markers in the body)
how is RA diagnosed?
-by a clinical history by rheumatologist or physio NB
-supported by imaging and blood tests
what is serology?
-a lab blood test - that tests for presence of antibodies
what are 2 important antibodies relevant to serology testing in RA patients?
-Anti CCP - anti cyclic citrullinated peptide
-rheumatoid factor (weak pos in normal pop)
what are examples of acute phase reactants that are elevated in any type of inflammation?
-ESR - erythrocyte sedimentation rate
-CRP - C reactive protein
how is RA different to OA?
RA
-bone erosion
-swollen inflamed synovial membrane
-cartilage wears away
-bony ankylosis (joint becomes fused with bone)
what is bony ankylosis?
when the joint becomes fused with the bone tissue
what are the articular clinical features of RA that can be seen in subjective and physical exam?
-small joints of hands and feet
-symmetrical poly arthritis (multiple areas)
-can also be seen in cervical, elbow, knees and ankles
- less seen in DIP joints and lumbar spine
describe pain and stiffness as seen in RA pts
-pain and stiffness in early morning
-‘’ & ‘’ after being in static positions
-better with small amount of movement but worse if very active
describe swelling in RA
-often large joint effusions - intra articular
-there can be heat - not redness!
other than pain, stiffness and swelling, what other features can be picked up in physical exam?
-reduced ROM
-muscle atrophy due to pain or disuse
-joint deformity
-rheumatoid nodules
what is an important outcome measure for RA?
health assessment questionnaire (HAQ)
