[Rheum] Polyarthritis Flashcards
what is rheumatoid arthritis (RA)?
a chronic autoimmune, inflammatory arthritis
what does RA present with?
- symmetrical synovitis (joint swelling for >6 weeks)
- pain the small joints of the hands and feet, improves with exercise
what is the 1st line ix for RA?
- bloods: RF, anti-CCP, ESR/CRP
- X-ray of the affected joints
what are the X-ray findings for RA?
- erosions
- loss of joint space
- Boutonniere’s deformity
what is the rx for RA?
- lifestyle modifications (exercise, wt loss, dietary advice)
- analgesia
- DMARDs with bridging steroids until sx control os manageable in an acute flare
what is the aim in RA rx and what is based off?
remission, based off DAS-28 score
what is the DAS-28 score?
scores the overall disease control by looking which joints are painful/swollen and coincides this with CRP/ESR
what is the 1st line pharmacological rx for RA?
monotherapy with conventional DMARD
- methotrexate
- sulfasalazine
- leflunomide
- hydroxychloroquine
what is done if target is not made with monotherapy?
tirate conventional DMARDs up +/- dual therapy
what is done if target is not made with dual therapy?
consider biological agents
*due to their high price, biologics are kept for pts with a severe burden of disease measured by DAS28 score (>5.1)
what can be seen on X-ray for osteoarthritis?
- loss of joint space and gull wing sign
- osteophytes
- multiple normal joints
red, scaly lesions on finger joints. dx?
Gottron’s papules (dermatomyositis)
episodes of white, cold digits. dx?
Raynaud’s phenomenon
telescopic digit. dx?
arthritis mutilans (psoriatic arthritis disease pattern)
what are the key features of RA?
- symmetrical synovitis
- no skin changes
- rheumatoid nodules
