Rheumatoid Arthritis

Question 1

Give symptoms of rheumatoid arthritis

Answer 1

• Morning stiffness
• Joint stiffness, pain and reduced ROM
• Minor joint swelling

Systemic issues too such as….
- Fever
- Numbness and tingling

Question 2

Give a clinical sign of rheumatoid arthritis

Answer 2

Z deformity of thumb

• due to hyperflexion of metacarpalphalangeal joint
• hyperextension of interphalangeal joints
• ulnar deviation of fingers

Question 3

What is rheumatoid arthritis?

Answer 3

Multi factorial systemic condition causing inflammation and destruction of synovial joints

Question 4

What extra articular features may present on RA patients?

Answer 4

Eye involvement, dry eyes or Sjögren’s syndrome

Amyloidosis

Pulmonary inflammation

Question 5

How is RA treated?

Answer 5

Holistic - improve quality of life

Combo of

• physiotherapy - improve joint stability through exercises
• drug therapy - slow disease and remove pain
• surgery - restore function

Question 6

What drugs may be given to an RA patient?

Answer 6

Analgesics to remove pain - cocodamol

NSAIDS to reduce inflammation

Disease modifying drugs - methotrexate used to slow immune process

Question 7

What dental implications can RA have?

Answer 7

Sjorgens syndrome causing dry mouth

Disability being a barrier to oral hygiene and access to care

Drug effects

• NSAIDS impair platelets so increase risk of bleeding
• methotrexate can cause oral ulcers and also means patient is immunocompromised leading to increased infection risk

Question 8

Rheumatoid arthritis mainly affects peripheral joints, what diseases affect the axial skeleton?

Answer 8

Seronegative spondyloarthritides

• ankylosing spondylitis (vertebrae fuse Anteriorly)
• Reiters disease