Rheumatoid Arthritis Flashcards
What is rheumatoid arthritis (RA)?
A common chronic inflammatory disorder
What is the prevalence of RA worldwide?
0.5 to 1 percent
In which gender is RA more common?
Women
Which age group has the highest incidence of patients with RA?
Ages 25 to 55
After which age does the incidence of RA decline?
Declines after 75 years of age
What is the cause of RA?
Complex and multifactorial
-genetic predisposition
-environmental factors
—cigarette smoking
- older age
- immunologic dynamics
What factors initiate the inflammatory process in RA?
Unknown
What does chronic inflammation of synovial tissue in RA lead to?
Joint deformity
Destruction of:
- cartilage
- bone
- tendons
- ligaments
- joints
What may antibodies in RA indicate?
Poorer prognosis
- rheumatoid factors
- anticitrullinated protein antibody (ACPA)
What do individuals with RA initially present with?
- pain
- stiffness
- swelling of multiple joints for greater than 6 weeks
What are some other symptoms of RA presentation?
- fatigue
- low grade fever
- loss of appetite
What joints are affected first in RA?
Small joints
- fingers
- thumbs
- wrists
Joints of the toes
Where may patients also experience pain in RA besides the small joints?
Large joints
- elbows
- shoulders
- ankles
- knees
What is a predominant feature of RA?
Morning stiffness -slowness or difficulty moving the joints when getting out of bed OR -after staying in one position too long -involves both side of the body -gets better with movement
Can the diagnosis of RA be made by 1 physical finding or laboratory result?
No
Which organization provides specific criteria for the diagnosis of RA?
ACR / EULAR
-European League Against Rheumatism
Which patients should be tested for RA?
Present with:
-synovitis in at least 1 joint
AND
-swelling of the joint that is not the result of another disease
What score do patients need to have on the ACR / EULAR classification criteria to be diagnosed with RA?
6 or higher
-out of 10
What is the primary goal of RA treatment?
Improve quality of life by:
-reducing pain
AND
-maintaining or improving functional abilities
What is the ideal goal of RA therapy?
-disease remission
OR
-low disease activity
What are additional goals of RA therapy?
- slowing destructive joint damage
- delaying disability
What does treatment of RA include?
- non-pharmacologic therapy
- pharmacologic therapy
When is aggressive treatment of RA emphasized?
In early RA
