Rheumatoid Arthritis

Question 1

Why is rheumatoid arthritis symmetrical?

Answer 1

Activated Fibroblast-like Synoviocytes (FLS) can migrate to other joints.

Question 2

What movement of joints has formed in swan neck as a result of RA?

Answer 2

Distal interphalangeal joint is flexed, proximal interphalangeal joint is hyper-extended

Question 3

What movement has occurred as a result of RA in Boutonierre hand?

Answer 3

Distal interphalangeal is hyperextended, proximal is flexed.

Question 4

List some symptoms of rheumatoid arthritis

Answer 4

Pain, swelling, skin nodules

Question 5

What changes happen to a joint in RA?

Answer 5

Synovitis (inflammed and enlarged synovial membrane), bone and cartilage erosion, angiogenesis

Question 6

What changes occur microscopically in a joint in RA?

Answer 6

Macrophages release cytokines, cytokines trigger inflammation and stimulate fibroblast like synoviocytes to proliferate. FLS, cytokines, stimulate RANKL which causes osteoclast differentiation, osteoclasts erodes bone.

Question 7

What role do neutrophils play in RA?

Answer 7

They will be present in the synovial fluid and their reactive oxygen species degrade bone and cartilage

Question 8

What cells are present in the synovial membrane of a joint?

Answer 8

Fibroblast like Synoviocytes

Question 9

Which joints of the wrist are affected in rheumatoid arthritis?

Answer 9

Distal interphalangeal joints, proximal interphalangeal joints, can include wrist