rheumatoid arthritis Flashcards
what antibodies are involved in RA?
rheumatoid factor and anti-CCP
what parts of the body are affected in RA?
small joints
squeezing hands and feet hurt - DIP spared
are the symptoms bilateral or unilateral?
bilateral
what are the features of RA?
prolonged morning stiffness
swelling of affected joints
systemic upset
what is a clinical sign of RA?
synovitis
what other extra-articular parts can be involved?
rheumatoid nodules
occular
ILD
pleural effusion
what investigations are used?
inflammatory markers - CRP, ESR/plasma viscosity, high synovial WBC
autoantibodies - anti-CCP, rheumatoid factor
x-ray
what will be seen on x-ray in early RA?
swelling
periarticular osteopenia
what will be seen on x-ray of late RA?
erosions
subluxation
what is the management of RA?
DMARDS
methotrexate - 1st line
sulfasalazine - pregnancy
add biologics
anti-TNF (infliximab)
T cell blocker
steroids for lare ups
what patients are biologics contraindicated in and why?
patients with previous TB
reactivates TB
what scoring system is used to measure grading on disease and activity in RA?
DAS-28
what would the DAS-28 score of someone in RA remission be?
<2.6
