Rheumatoid Arthritis Flashcards
What is it?
A chronic systemic inflammatory condition that affects synovial joints and periarticular tissues
What causes it?
It is an autoimmune condition
How is it characterised?
Symmetrical, deforming, peripheral polyarthritis
Is there a genetic link?
Yes, it is related to HLA DR1/DR4 and sufferers often have rheumatoid factor in their blood
Which joints does it affect?
It mainly affects the small joints such as the phalangeal joints and the wrists
Is it common?
Prevalence in the UK is 1.5% of women and 0.5% of men
Who does it affect?
It is much more common in women and peak incidence is 40 years old
Risk factors (8)
High birthweight, smoking, silica exposure, alcohol abstinence, obesity, Diabetes, rheumatoid factor, anti-citrullinated antibody
Symptoms (9)
swelling, pain, stiffness, affects the small joints, worse in the morning, fatigue, fever, rigors, weight loss
Signs (10)
Symmetrical affected areas, swollen MCP and PIP joints, ulnar deviation, heberdens and bouchards nodes, boutonnieres and swan neck deformities, z-deformity of thumbs, ruptured extensor tendons, nodules on elbows, lymphadenopathy, vasculitis
Differentials (4)
Osteoarthritis, Gout, Septic arthritis, Seronegative
What bloods would you do? (7)
FBC, ESR, CRP, LFT, TFT, Rheumatoid Factor, Anti-citrullinated peptide,
Other investigations (2)
X-ray, urinalysis
Treatment (6)
DMARDs-start with sulfasalazine, methotrexate; NSAIDs, physiotherapy, occupational therapy, surgery, manage risk factors for CVD due to increased risk
Complications (8)
restricted mobility, difficulties with activities of daily living, depression, vasculitis, anaemia, orthopaedic complications, osteoporosis, dry eye syndrome
