Rheumatoid Arthritis Flashcards
1
Q
What is RA
A
- A chronic systemic inflammatory disease
- Characterised by a symmetrical, deforming, peripheral polyarthritis
2
Q
When does RA usually present
A
5-6th decade
3
Q
RA affects men or women more
A
Women 2:1
4
Q
Typical presentation of RA
A
- Symmetrical swollen, painful and stiff small joints of hands and feet
- Worse in morning
- Can fluctuate
- Larger joints may become involved
5
Q
Less common presentation of RA
A
- Sudden onset, widespread, arthritis
- Recurrent mono/polyarthritis, of various joints
- Persistent monoarthritis (often knee, shoulder, hip)
- Polymyalgic onset (vague limb girdle aches)
- Systemic illness
6
Q
Symptoms of systemic illness associated with RA
A
- Fever
- Fatigue
- Weight loss
- Pericarditis + pleurisy
7
Q
Is systemic illness more common in men or women in RA
A
Men
8
Q
Signs of RA
A
EARLY -Swollen MCP, PIP, wrist or MTP joints -Often symmetrical -Tenosynovitis or bursitis LATER -Ulnar deviation of fingers -
9
Q
What are Bouchard’s nodes
A
- Bony swelling of PIP joints
- Due to antibody deposition to the synovium
- Also seen in OA
10
Q
Extra-articular signs of RA
A
- Nodules (elbows + lungs)
- Vasculitis
- Lymphadenopathy
- Pleural + pericardial effusion
11
Q
Investigations of RA
A
- Rheumatoid factor (+ve ~70%)
- ACPA/anti-CCP, highly specific (~98%)
- ESR/CRP
- X-ray/USS
12
Q
What haematological condition can RA cause
A
Anaemia of the chronic disease (secondary disease)
13
Q
Criteria for diagnosing RA
A
Points are given depending on the severity of each category
- Joint involvement
- Serology
- Acute phase reactants
- Duration of symptoms
14
Q
Criteria for diagnosing RA regarding joint involvement
A
- 1 large joint = 0
- 2 large joints = 1
- 1-3 small joints = 2
- 4-10 small joints = 3
- > 10 joints (at least 1 small) = 5
15
Q
Criteria for diagnosing RA regarding serology
A
- -ve RF + -ve anti-CCP = 0
- Low + RF/anti-CCP = 1
- High +ve RF/anti-CCP = 3
