Rheumatoid arthritis Flashcards
1
Q
What is the definition of rheumatoid arthritis?
A
Chronic autoimmune disorder causing symmetrical polyarthrtits
2
Q
How common is rheumatoid arthritis?
A
Affects 0.5-1% of the population, peaking between the ages of 30-50 years old
3
Q
What is the pathophysiology of rheumatoid arthritis?
A
- Synovitis
- Infiltration by inflammatory cells
- Generation of synovial blood vessels
- Activated endothelial cells produce adhesion molecules
- Synovium groves over the surface of cartilage = produces pannus
- Pannus destroys articular cartilage = produces bony erosions
4
Q
What are the risk factors/aetiology of rheumatoid arthritis?
A
- Woman before menopause – caused by sex hormones
- Genetic
- Family history
- Smoking
5
Q
What are the signs/symptoms of rheumatoid arthritis?
A
- Pain in joints
- Early morning stiffness – lasting more than 30 minutes
- Swelling in the small joints of the hands and feet
- Spindling of the fingers – due to swelling in the PIPJ but not the DIPJ
- Rheumatoid nodules
- Joint instability
- Subluxation (partial dislocation)
- Boutonniere deformity
- Ulnar deviation and Z shaped thumb
- Swan neck deformity
- General symptoms: tiredness, weight loss
6
Q
What investigation are conducted in suspected rheumatoid arthritis?
A
- FBC – normochromic, normocytic anaemia and thrombocytosis
- ↑ ESR/CRP
- Anti-CCP serum autoantibodies
- Rheumatoid factor
- X-ray
- Synovial fluid culture
7
Q
What are the pharmacological treatments for rheumatoid arthritis?
A
- NSAIDs
- Paracetamol/codeine
- Steroids
- DMARDs (disease modifying anti rheumatic drugs) e.g. methotrexate, sulfasalazine
- Biological DMARDs e.g. infliximab
8
Q
What are the non pharmacological treatments for rheumatoid arthritis?
A
- Physiotherapy
* Smoking cessation
