RA - Clinical presentation Flashcards
What is the definition of RA?
- Chronic inflammatory autoimmune condition.
2. Characterised by pain, swelling and joint stiffness
What is the epidemiology of RA?
Females 50 - 75 years
What is the etiology of RA?
- Unknown cause
2. Associated with HLA DR 4 and HLA DR1 gene
What is the pathophysiology of RA?
~ autoimmune inflammatory response~
- inflammatory joint effusion and synovial hypertrophy,
- progressive destruction and deterioration of cartilage and bone
Name 4 major rhuematoid presentation of RA?
- Polyarthritis > 4 joints affected
- Symmetrical
- Morning stiffness
- Weakened grip
- Pain and stiffness relieved by activity
What are the 4 distinguishing features of RA found in the hands?
- Protrusion of the ulnar head at the wrist
and Ulnar deviation of the fingers - Swan neck deformity
- Bouteniere’s deformity
What is the ‘swan neck deformity’
- Flexion of distal interphalangeal
2. Hyperextention of Proximal interphalangeal
What is the ‘Bouteniere’s deformity’
- Distal interphalangeal joint - hyperextention
2. Proximal interphalangeal is flexed
Which 5 major organs are affects in extra articular manifestation of RA?
- Heart
- Lungs
- Skin / Eyes
- Nervous system
What increases the likelihood of extra articular manifestations of RA?
- Positive rheumatoid factor
Extra articular manifestations : Skin
Rheumatoid nodules (non tender, firm swellings)
Extra articular manifestations : Heart
- Pericarditis
- Endocarditis
- Increases risk of MI/STROKE
- Anaemia of chronic disease
Extra articular manifestation : Lungs
- Pleural effusions
2. Pulmonary fibrosis
Extra articular manifestation : Nervous system
Peripheral neuropathy
Extra articular manifestation : Eyes
- dry eyes
2. Episcleritis
