Rheumatoid Arthritis Flashcards
What is arthritis?
Inflammation of a joint or joints
What are the general symptoms of arthritis?
Pain Stiffness Swelling Functional Impairment Systemic symptoms
What are the signs of arthritis?
Tenderness Swelling Restriction of movement Heat Redness Systemic features
What is rheumatoid arthritis?
Chronic autoimmune systemic illness characterised by a symmetrical peripheral arthritis and other systemic features
What features are used to classify rheumatoid arthritis?
Morning stiffness Arthritis of 3 or more joint areas Arthritis of hand joints Symmetric arthritis Rheumatoid nodules Serum rheumatoid factor Radiographic changes
What is the aetiology of rheumatoid arthritis?
Genetic (DRbeta1)
Environmental (Smoking, Chronic infection)
What is the age onset of rheumatoid arthritis?
Peak age 4th/5th decade but may occur at any age from 16
What investigations are used to diagnose rheumatoid arthritis?
Rheumatoid factor test (IgG, IgM)
Anti cyclic citrullinated antibodies (anti CCP, ACPA)
X ray
Ultrasound
What are the non specific systemic features of rheumatoid arthritis?
Fatigue
Weight loss
Anaemia
What are the specific areas of the body which rheumatoid arthritis may affect?
Eyes Lungs Nerves Skin Kidneys
How is rheumatoid arthritis assessed?
Disease activity score
DAS <2.4 represents clinical remission
DAS >5.1 represents eligibility for biologic therapy
What are the different treatment options for rheumatoid arthritis?
Medicines
Injections
Therapies
Surgery
What are the therapeutic categories for treating rheumatoid arthritis?
NSAIDs
Disease modifying anti rheumatic drugs (DMARD)
Biologics
Corticosteroids
What types of DMARDs are used to treat rheumatoid arthritis?
Methotrexate
Sulfasalazine
Hydroxychloriquine
Lefunomide
What biologics are used to treat rheumatoid arthritis?
TNFalpha inhibitors IL-1 inhibitors (Anakinra) Anti B cell therapies (CD20, Rituximab) Anti T cell therapies (Abatacept) IL-6 inhibitors (Tocilizumab)
