RA - atlanto-axial subluxation + managing RA Flashcards
A-A Subluxation
Atlantoaxial instability occurs in 50-?% of patients with RA of the ? spine, as the transverse and apical ? are destroyed by ?.
They present with ? pain and ?, as well as cervical ?.
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A-A Subluxation
XR (APO, lateral and ? peg views required) and ? of the cervical spine are diagnostic.
Management is ? ? of the spinal cord and to ? the
involved segment of the spine.
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RA MX
Once diagnosis has been confirmed, ? DMARD treatment should
be started as soon as possible if not contraindicated.
? is first line, usually combined with ? (as
different side effect profile).
?-term glucocorticoids {IM ?) are also prescribed at
diagnosis to reduce the ? before the ? become effective.
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RA MX
? are often also essential in a patient’s management to relieve ? pain and ? stiffness.
Further short ? courses may be required to deal with ?.
Lifestyle measures are also vital, including stopping ? {?? risk and
decrease ? effectiveness), and ? etc.
??? management is essential, for help with ??? and home adaptions etc.
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Biologic agents (e.g. ?, ?) are indicated if at least ?DMARDs have been tried (one of which must be ?), and there is a disease activity score (DAS) >?.
The disease activity score is based on number of ? sites, number of ? sites, ? or ? and patient ? of disease activity.
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RA MX
Surgery is also important in long-term management;
?: in monoarticular disease to reduce the bulk of ? tissue.
Excision ?;
o Of the ulnar ? to reduce the risk of ? tendon damage.
o Of ? heads to reduce pain and pressure points.
? joint replacement.
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