Rheumatoid arthritis Flashcards
what is rheumatoid arthritis?
serious autoimmune systemic disease involving the joint synovium
what is detected in rheumatoid arthritis?
-autoantibodies
-rheumatic factors (if present= seropositive if not present=seronegative)
is RA symmetrical poly arthritis?
yes- affects ALL synovial joints- toes, ankles, knees, arms, shoulders and neck
what are the symptoms of RA?
-multi joint pain
-multi joint swelling
-multi joint morning stiffness
-fever
-numbness/tingling
what are the early signs of RA?
symmetrical synovitis of MCP, PIP and wrists
what are mid stages of RA?
deformity due to destruction of joints
-hyperflexion of MCP
-hyperextension of PIP
-tendons pull to ulnar side of hand (pinkie side)
what are late stages of RA?
tendons pulled laterally-cant grip
- loss of function
-need joint replacement to restore function
what is the treatment of RA?
Holistic treatment
-physiotherapy- muscle exercises to maintain function for as long as possible
-occupational- assess home and provide aids for independent living e.g stair lift
-drugs - analgesics and NSAIDS for pain
-immune modulators to slow progression e.g hydroxychloroquine and methotrexate
surgery- to restore function
what are the dental aspects of RA?
-access to care
-reduced manual dexterity- difficult to maintain good OH
-associated with sjogrens syndrome- dry mouth - increase caries and p disease
-joint replacement-ab prophylaxis
-chronic anaemia- interfere with sedation
how do drugs used affect dentistry?
NSAIDS- bleeding and chronic=oral ulceration
Steroids- infection risk
Hydroxychloroquine- oral linchen
methotrexate- oral ulceration
what condition is caused by seronegative RA?
spondyloarthritis (ankylosing spondylitis)
what does ankylosing spondylitis cause?
inflammation of the spinal joint - discs become inflamed and fuse together- unable to twist/turn/bend (higher in males)
what are the effects of ankylosing spondylitis?
-lack of axial movement
-rigid
-kyphosis
-lower back pain
-compressed chest-limited expansion can make respiratory diseases worse
what is the treatment of ankylosing spondylitis?
NSAIDS
analgesics
holistic therapies
immune modulators- methotrexate and hydrochloroquine (delay progress)
surgery- replacement for loss of function
what are the dental aspects of ankylosing spondylitis?
-limited mouth opening
-cant lie flat
-limited neck flexion
-respiratory problems
