Rheumatoid Arthritis Flashcards
What is Rheumatoid Arthritis?
Systemic, chronic inflammatory disease n which chronic polyarthritis involves diarthrodial joints symmetrically and bilaterally
How is humoral immunity associated with the pathogenesis of rheumatoid arthritis?
Lymphocytes and plasma cells accumulate in the synovium and produce Igs. Plasma cells also produce Rheumatoid Factor against the Fc portion of IgG. These immune complexes form and can activate complement and cellular immunity.
How is cellular immunity associated with rheumatoid arthritis?
Abundant T lymphocytes in rheumatoid synovium are frequently activated
What is the inciting event that leads to RA?
A genetically susceptible person is exposed to some insult/infection resulting in Ab formation
What is the term used to describe fibrin exudate found in the joint space of early RA?
Rice bodies
Describe pannus formation and its role in RA pathogenesis
Pannus is an inflammatory cell lining that extends over the articular cartilage separating the cartilage from the synovial fluid. The pannus erodes the articular cartilage and adjacent bone.
Describe the bone loss in RA
Juxta-articular bone loss - immediately adjacent to both sides of the joint
The term for fibrous fusion of joints? For bony fusion?
Ankylosis
Bony Ankylosis
What is the characteristic lesion of RA found throughout the body?
Rheumatoid Nodules
What are spondyloarthropathies?
Seronegative arthritis mostly linked to HLA-B27
What are some spondyloarthropathies?
- Ankylosing spondylitis
- Reiter Syndrome
- Psoriatic arthritis
- Arthritis associated with inflammatory bowel disease
What are common features of spondyloarthropathies?
- Seronegativity for RF and other serologic markers of RA
- Association with class I histocompatibility antigens, (particularly HLAB27)
- Sacroiliac and vertebral involvement
- Asymmetric involvement of of only a few peripheral joints
- Tendency to inflammation of periarticular tendons and fascia
- Systemic involvement of other organs, especially uveitis, carditis and aortitis
- Preferential onset in young men
Describe the pathogenesis of ankylosing spondylitis
Inflammatory arthropathy of the vertebral column and sacroiliac joints bilaterally. It then ascends to the spinal column by involving the small joints of the posterior elements of the spine.
What is reiter syndrome?
Reactive arthritis
- Seronegative polyarthritis
- Conjunctivitis/uveitis
- Nonspecific urethritis
“Can’t see, can’t pee, can’t climb a tree”
What are the typical inciting agents of reiter syndrome?
Veneral exposure or an episode of bacillary dysentery
