Rheumatoid arthritis

Question 1

What is Rheumatoid arthritis

Answer 1

An auto immune systemic inflammatory illness characterised by symmetrical joint inflammation an variable extra articular features

Question 2

What is typical Rheumatoid arthritis defined as

Answer 2

1. Symmetrical arthritis
2. Hand joints
3. At least three areas
4. Morning stiffness
5. Rheumatoid nodules
6. Serum rheumatoid factor
7. Radiographic changes

Question 3

List some of the clinical features of Rheumatoid arthritis

Answer 3

Typical pattern is of involvement of the peripheral joints, including the upper and lower limbs but sparing the Distal interphalangeal (DIP) joints

Question 4

List some of the symptoms of Rheumatoid arthritis

Answer 4

1. There will be pain in or around the joint sometimes with myalgia (muscle pain) which may be increased in the morning or when rest
2. Early morning stiffness lasting longer than 30 mins
3. Dry eyes, dry mouths

Question 5

What other body systems can Rheumatoid arthritis affect

Answer 5

1. Cardiovascular
2. Respiratory
3. Renal
4. Liver
5. Skin
6. General

Question 6

How can Rheumatoid arthritis affect the Cardiovascular system

Answer 6

1. Myocarditis
2. Pericarditis
3. Valve inflammation

Question 7

How can Rheumatoid arthritis affect the respiratory system

Answer 7

Pulmonary nodules/ fibrosis

Question 8

How can Rheumatoid arthritis affect the renal system

Answer 8

Amyloidosis

Question 9

How can Rheumatoid arthritis affect the hepatic system

Answer 9

Hepatic impairment

Question 10

How can Rheumatoid arthritis affect the skin

Answer 10

1. Palmar erythema
2. Subcutaneous rheumatoid nodules

Question 11

How can Rheumatoid arthritis affect a person generally

Answer 11

1. Malaise
2. Anaemia of chronic disease
3. Thrombocytopenia

Question 12

List some of the signs of Rheumatoid arthritis

Answer 12

1. Boggy swelling or affected joints which may be hot tender and sometimes red
2. Swan neck/ boutonnniére deformity of the fingers (z shaped thumb)
3. Ulnar deviation at the metacarpophalangeal (wrist) joints

Question 13

List some radiographic signs of early Rheumatoid arthritis

Answer 13

1. Periarticular osteoporosis
2. Periarticular erosions (action of synovitis on bare area of bone)

Question 14

List some of the radiographic signs of late Rheumatoid arthritis

Answer 14

1. Joint space narrowing
2. Subluxation/ dislocation
3. Ankylosis

Question 15

What do periarticular signs of Rheumatoid arthritis include

Answer 15

1. Rheumatic nodules: rubbery swellings topically over the elbows
2. Bursitis/tenosynovitis

Question 16

How many people are affected by Rheumatoid arthritis

Answer 16

1%

Question 17

Is Rheumatoid arthritis more common in men or women

Answer 17

Women

Question 18

Rheumatoid arthritis incidence increases with what factor?

Answer 18

Age after 50 years

Question 19

How can we manage Rheumatoid arthritis

Answer 19

1. Education in regards to the nature of the disease
2. analgesics including NSAIDs
3. Disease modifying anti rheumatic drugs (DMARDs)

Question 20

What do disease modifying anti rheumatic drugs (DMARDs) aim to do

Answer 20

Reduce symptoms and prevent joint damage