RA Flashcards
Are women or men more likely to have RA
women
When is the onset for RA
35-50
Which populations have the highest levels of RA? The lowest?
Aboriginal
Asian
What is the pathophysiology of RA
Autoimmune disease
- In response to immunologic factors synovial membranes become inflamed
What triggers RA
Genetic susceptibility and environmental triggers
What are the characteristics of synovitis
- Hyperplasia (synovial cell proliferation)
- Increased vascularity
- Infiltration of inflammatory cells - resulting in the production of enzymes that causes inflammation
- Articular damage cased by pannus
what is pannus
granulation tissue formed within synovium
What is the difference between joint damage in OA and RA
In an RA affected joint damage is throughout the joint surface (unlike OA where you see the most damage near site of stress)
- In RA there can also be bone damage leading to osteoporosis
What happens when a joint is affected by RA
- In response to immunologic factors, the synovium becomes swollen and cells begin to proliferate
- A densely cellular membrane )pannus) spread over the cartilage and erodes the underlying cartilage and bone
- Pannus can cause fibrous scar tissue, adhesions, and ankylosis on opposite articular surfaces
- Bone becomes more osteopenic, ligaments and tendons are damage, surrounding muscle deteriorates
What is the response of the synovium to immunologic factors
becomes swollen and cells begin to proliferate
What is the result of pannus spreading over the articulare cartilage
erodes the underlying cartilage and bone
What is the result of pannus spreading to the opposite articular surface
creates fibrous scar tissue, adhesions, and ankylosis
What is the result of tendon and ligament damage in RA
increased risk of rupture
What is the result of ligament damage and deteriorating musculature
leaves joints unstable and prone to deformity
Familial history of RA increases overall risk by ___
2x
What is the genetic marker for RA
Rheumatoid factor HLA-DR4
Rheumatoid factor (RF) HLA-DR4 is present in ___% of people with RA
80%
Rheumatoid factor (RF) HLA-DR4 accounts for ___% of the genetic risk in RA
30%
High RF can also be present in people with what conditions?
Lupus, syphilis, chronic or idiopathic pulmonary fibrosis
when else might you see elevated levels of RF
in aging population - 5-10% of healthy people>60yrs have it
What are the risk factors for RA
- Genetics
- Pregnancy & hormonal factors
- Environmental factors - Smoking, occupation, diet,