RA - Background + Examination

Question 1

RA affects around 3% of ?, and 1% of ? over their lifetimes.

Pre-? ? affected more than men.
o No gender differences post-?.

The disease is ?, yet inheritance is ?.

The differential diagnosis in early RA includes ? arthritis, seronegative
?, ? ? or acute ? osteoarthritis.

Answer 1

meno
women
meno
familial
sporadic
reactive
spondyloarthopathies
poly rheum
nodal

Question 2

RA classically presents as a ? polyarthritis;

o The classical patient is a 30-? year old female.
o Presentation is with red, ?, painful & ? ? joints,
typically of the hands/?.
o This then progresses to affect ? joints (still ?).
o This is worse in the ?, evolving over weeks to months (70%).

Answer 2

symmetrical
50
warm
swollen
peripheral
feet
larger
symmetrical
morning

Question 3

Presx

In 15% of cases, there is ?onset of symptoms over days/?.
–> • This presentation is associated with ? prognosis.
o General ?, ? loss and disturbed ? common.
o ? features may be present (see below).
o More rare presentations are ? RA (recurring mono/polyarthritis), ? mono-arthritis, or ? illness with ?
symptoms.

Answer 3

rapid
overnight
better
malaise
weight
sleep
extra-articular
palindromic
persistent
systemic 
extra-articular

Question 4

Hands;

Involvement of the small joints of the hands is most common, with joint
? leading to ? as the disease progresses.
? are classically spared in RA.
Severe disease can lead to ?(fusion) across the joint, leading to severe and ?deformities.

Answer 4

erosion
deformities
DIPJs
ankylosis
fixed

Question 5

There are certain characteristic deformities;

o ? ? at the MCPJs.
o ? ? at the wrist.
0 Boutonniere deformity: hyperflexed ?s, hyperextended ?s.
0 ? ? deformity: hyperflexed DIPJs, hyperextended PIPJs.
0 z deformity in the thumb: ?MCPJs, ? at IPJ.
0 ? is a late deformity;
–> • Volar ? at the MCPJs / ?.

Answer 5

ulnar deviation
radial deviation
PIPJ
DIPJ
Swan neck
flexed
extension
subluxation
subluxation
wrist

Question 6

Feet;
MTPJ ? is one of the earliest manifestations.
- The foot becomes ? and a ?-toe deformity develops.

?/? can occur due to exposure of the metatarsal heads to ? due to migration of the protective ? ?.

Answer 6

swelling
broader
hammer
callouses/ulcers
pressure
fat pad

Question 7

Large Joint Involvement;
- The ? is most commonly affected, then the ?/?.
In the knee, a genu ?deformity and secondary ??can develop.
Once severely affected, large joints require ? ? ? to restore function.

Answer 7

knee
shoulder
hip
valgus
OA
total joint replacement