Rheumatoid arthritis Flashcards

1
Q

What is rheumatoid arthritis?

A

Chronic inflammatory autoimmune disease

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2
Q

What is the onset of rheumatoid arthritis?

A

Gradual onset over days to weeks

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3
Q

Who is more commonly affected by rheumatoid arthritis?

A

Females

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4
Q

How long does morning stiffness usually last in someone with rheumatoid arthritis?

A

More than 30 minutes

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5
Q

What is the main presentation of rheumatoid arthritis?

A

symmetrical, polyarticular inflammatory arthritis involving the small joints of the hands, wrists, and feet.

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6
Q

Which joints are usually spared in someone with rhuematoid arthritis?

A

Distal interphalangeal joints

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7
Q

What improves the pain of rheumatoid arthritis?

A

Movement

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8
Q

How does rheumatoid arthritis get worse?

A

Larger joints become affected

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9
Q

What test will be positive in someone with rheumatoid arthritis?

A

The squeeze test

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10
Q

What is the squeeze test?

A

Discomfort on squeezing across the metacarpal or metatarsal joints

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11
Q

What are the characteristic hand features of rheumatoid arthritis?

A

Wrist subluxation.
Metacarpophalangeal subluxation.
Swan-neck finger deformity
Boutonniere finger deformity
Ulnar deviation of proximal phalanges.
Z-shaped thumb.

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12
Q

What are the characteristic feet features of rheumatoid arthritis?

A

Hallux valgus.
Hammer toes.
MTP subluxation.

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13
Q

How else can rheumatoid arthritis present?

A

Acute onset with marked systemic disturbance
Relapsing/remitting monoarthritis of different large joints

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14
Q

Which part of the spine tends to be affected in someone with reumatoid arthritis?

A

The cervical spine- atlanto-axial joint (C1-C2).

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15
Q

How can the eyes be affected in someone with rheumatoid arthritis?

A

keratoconjunctivitis sicca (most common- dry eyes)
episcleritis (erythema) and scleritis (erythema and pain)

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16
Q

What are the early x-ray changes in someone presenting with rheumatoid arthritis?

A

loss of joint space
juxta-articular osteoporosis
soft-tissue swelling

17
Q

What are the late x-ray changes in someone presenting with rhuematoid arthritis?

A

periarticular erosions
subluxation

18
Q

What is the first line antibody test for patients with suspected rheumatoid arthritis?

A

Rheumatoid factor (RF)

19
Q

What type of antibody is RF usually?

A

IgM

20
Q

How can RF be detected?

A

Rose-Waaler test: sheep red cell agglutination
Latex agglutination test

21
Q

What are high RF levels associated with?

A

Severe progressive disease

22
Q

What other conditions are associated with a positive RF?

A

Felty’s syndrome
Sjogren’s syndrome
Infective endocarditis
SLE

23
Q

What other antibody can be used in the diagnosis of rheumatoid arthritis?

A

Anti-cyclic citrullinated peptide antibody

24
Q

What is the importance of anti-ccp antibody in the diagnosis of rheumatoid arthritis?

A

Detectable up to 10 years before the development of rheumatoid arthritis