Rheumatoid arthritis

Question 1

What is rheumatoid arthritis?

Answer 1

Chronic autoimmune systemic illness characterised by symmetrical peripheral arthritis and other systemic features

Question 2

What is the epidemiology of rheumatoid arthritis?

Answer 2

1% populatipn
emales > males
From age of 16, most in 4th-5th decade

Question 3

What is the classification of joint involvement?

Answer 3

1 large joint
10 large joints
3 small joints +/- large joints
10 small joints +/- large joints
>10 joints with at least 1 small joint

Question 4

What is the classification of serology?

Answer 4

Negative RF and ACPA
Low + RF or ACPA
High + RF or ACPA

Question 5

What is the classification with acute phase reactants?

Answer 5

Normal CRP and ESR

Abnormal CRP or ESR

Question 6

What is the aetiology of rheumatoid arthritis?

Answer 6

Genetic

Environment- smoking, chronic infection

Question 7

What is the pathology of rheumatoid arthritis?

Answer 7

Inflammation of synovial membrane and joint capsule

Thinning of cartilage

Question 8

What are the signs and symptoms of rheumatoid arthritis?

Answer 8

Pain, tenderness
Stiffness, esp morning, immobility, poor function, limitation of movement
Swelling, deformity
Systemic- fatigue, weight loss, myalgia, eyes, lungs, nerves, kidneys, CVS, malignancy

Question 9

What investigations are done for rheumatoid arthritis?

Answer 9

Immunology- rheumatoid factor, anti CCP and anti CPA
Xray
US

Question 10

What is the treatment of rheumatoid arthritis?

Answer 10

NSAIDs
Disease modifying anti-rheumatic drugs- e.g. methotrexate
Biologics- rituximab
Corticosteroids
Surgery

Question 11

What are the outcomes of rheumatoid arthritis?

Answer 11

33% out of workplace 2 years post diagnosis

Life expectancy shortened by 7 years