Rheumatoid Arthritis

Question 1

What is RA?

Answer 1

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease of unknown etiology that primarily involves the joints.

Question 2

What are the predominant symptoms of RA?

Morning stiffness, or stiffness after prolonged inactivity, often lasts more than an hour in the active inflammatory stage.

Answer 2

Typically, the disease onset is insidious, with pain, stiff ness, and swelling of the joints

Question 3

Up to one third of patients with RA experience acute onset of polyarthritis associated with systemic symptoms including

Answer 3

• Fatigue
• Myalgia
• Depression
• Low-grade fever
• Weight loss

Question 4

The most common joints involved in the early stage of the disease are the ?

Answer 4

• Metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the fingers
• Interphalangeal joints of the thumb,
• Wrists
• Metatarsophalangeal joints of the toes.

Question 5

Jt. least involved in RA?

Answer 5

Distal interphalangeal (DIP) joints

Question 6

1987 Revised American Rheumatism Association Criteria for Classification of Rheumatoid Arthritis

Morning stiffness: 1.

Arthritis of three or more joint areas: 2.

Arthritis of hand joints: 3.

Symmetrical arthritis: 4.

Rheumatoid nodules: 5.

Serum rheumatoid factor: 6.

Radiographic changes: 7.

Answer 6

1. Morning stiffness in and around the joints, lasting at least 1 hour, before maximal improvement.
2. Soft tissue swelling of fluid (not bony overgrowth alone) observed by a physician in at least three joint areas simultaneously. The 14 possible areas are right or left PIP, MCP, wrist, elbow, knee, ankle, and MTP joints.
3. At least one area swollen (as defined above) in a wrist, MCP, or PIP joint.
4. Simultaneous involvement of the same joint areas (as defined above for criterion 2) on both sides of the body (bilateral involvement of PIP, MCP, or MTP joints is acceptable without absolute symmetry).
5. Subcutaneous nodules, over bony prominences, on exterior surfaces, or in juxtaarticular regions, observed by a physician.
6. Demonstration of abnormal amounts of serum rheumatoid factor by any method for which the result has been positive in less than 5% of normal controls.
7. Radiographic changes typical of rheumatoid arthritis on posteroanterior hand and wrist radiographs, which must include erosion or unequivocal bony decalcification localized in or most marked adjacent to the involved joints (osteoarthritis changes alone do not
   qualify) .