Rheumatoid arthritis Flashcards
Does RA affect men more commonly
no
What environmental factors can worsen Ra?
Smoking
Describe RA as a condition
An Autoimmune inflammatory arthritis characterised by symmetrical swelling in multiple joints
How does RA show immunological abnormalities?
Immunological mechanisms normally fighting infection/malignant cells target normal tissue.
T lymphocytes produce cytokines which exacerbate inflammation
Describe the pathology of RA
Synovitis, macrophages and osteoclasts form chronically inflamed tissue (pannus) extending from margins and eroding articular cartilage.
Cartilage and bone erosion lead to deformity
When is the peak incidence of RA?
30-50, insidiously
What will RA patients experience
Pain, swelling, and stiffness which is worse on waking and eases as the day progresses.
Which joints does RA affect
Primarily small ones, MCPs, DIPs, PIP joints
What are the 3 types of deformity that can affect the hand with RA
Ulnar deviation, Boutonniere and swan neck deformity
Recall how RA affects the foot.
Forefoot synovitis. Proximal phalanges sublux dorsally, easily palpated, fat pad protection lost, feeling of walking on marbles,
How does RA affect the cervical spine
Atlantoaxial subluxation - The atlas slips forward on axis reducing space for spinal cord. Can cause neck pain. Odontoid peg may move upwards through the foramen magnum threatening spinal cord and brainstem
Name the subcutaneousnodules found in RA patients, and which RA patients are they more common in
Rheumatoid nodules, rheumatoid factor
What other extra-articular features apart from nodules can RA form?
Tenosynovitis, bursitis, carpal tunnel syndrome
What are the systemic symptoms of RA
Low-grade fever, weight loss lethargy and fatique.
WHat is felty syndrome
Associate of RA, with splenomegaly (Big spleen) and leukopenia. Can lead to frequent infection
