Rheumatoid Arthritis Flashcards
overview
chronic inflammation of the synovial lining of the joints, tendon sheaths and bursa
synovial inflammation is called
synovitis
RA is _x more common in __ than __
3
women
men
genetic associations of RA
HLA DR4 (often present in RF positive)
HLA DR1 (occasionally present in RA patients)
RF is an autoantibody present in around __ percent of RA patients
70
RF targets the __ portion of the __antibody
Fc
IgG
2 antibodies involved in RA
anti-CCP
key symptoms RA
symmetrical distal polyarthropathy
pain
swelling
stiffness
systemic symptoms of RA
fatigue
weight loss
flu like illness
muscle aches and weakness
RA pain is ___ after rest and ___ with activity
worse
better
palindromic rheumatism overview
self limiting short episodes of inflammatory arthritis
having positive RF or anti-CCP antibodies indicates it may develop to full RA
common joints affected
Proximal interphalageal
metacarpophalangeal
metatarsophalangeal
wrist and ankle
cervical spine
knee, hips, shoulder
joints almost never affected by RA
distal interphalangeal
boutonnière deformity
bent up finger
key signs in the hands
z shaped deformity
swan neck deformity
boutonnières deformity
ulnar deviation
extra-articular manifestations
pulmonary fibrosis
bronchiolitis obliteratans
Felty’s syndrome
sjrogens
anaemia
CVD
eye manifestations
lymphadenopathy
carpel tunnel
amyloidosis
eye manifestations
scleritis
episcleritis
keratitis
karatoconjuctivitis sicca
cataracts
retinopathy
investigations
RF
if negative, anti-CCP
CRP, ESR
XRay
US can confirm synovitis
referral guidelines
referral recommended for any adult with persistent synovitis, even if negative RF, antiCCP and inflammatory marker. urgent if involving the hands, feet, multiple joints or symptoms present >3 months
differentials
SLE
fibromyalgia
infectious arthritis
osteoarthritis
gout
reactive arthritis
septic arthritis
sarcoidosis
seronegative spondyloarthritis
arthralgia
joint stiffness
arthritis
joint pain, tenderness and stiffness
enthesitis
inflammation where tendons and ligaments join to bones
seen in psoriatic arthritis
dactylitis
sausage fingers
