*Rheumatoid Arthritis

Question 1

RA- Age of onset

Answer 1

20-30’s

Question 2

RA-Male/Female/Race

Answer 2

Females 2-3x more

Question 3

RA- Family History

Answer 3

Positive

Question 4

RA- Health History Risk Factors

Answer 4

Pregnancy and OCA use decreases risk

Question 5

RA- Type of Onset and Progression

Answer 5

Onset: Insidious

Progression: slow/rapid progression

Question 6

RA- Symptom location

Answer 6

Multiple joints

Bilateral/symmetric

Question 7

RA- Symptom descriptors

Answer 7

pain/soreness

stiffness

Question 8

RA- Aggravating Factors

Answer 8

Rest and inactivity

Post-rest gel: more than 30 minutes

Question 9

RA- Alleviating Factors

Answer 9

Movement

Question 10

RA- 24 hour report

Answer 10

AM stiffness-severe

Question 11

RA- Review of Systems

Answer 11

Fatigue, Anorexia, Weight loss

Multiple Systems involved:

• scleritis
• interstitial lung disease- difficult breathing
• vasculitic
• etc.

Question 12

RA- ROM/Mobility

Answer 12

Contractures over time with deformities

Question 13

RA- Palpation/Observation

Answer 13

Common deformities: wrist, hand, feet

Rheumatoid nodules

Edema/warmth (swelling)

Question 14

RA- Complications

Answer 14

C1-2 subluxation

Cardiopulmonary compromise

Deformity-disability

Question 15

RA- Lab Tests

Answer 15

Rheumatoid Factor, but…

Question 16

RA- Diagnostic Imaging

Answer 16

Plain Films:

Joint space narrowing

cortical bone thinning

erosions

osteoporosis

Question 17

RA- Clinical Findings for Diagnosis

Answer 17

4 most be present for at least 6 weeks:

1) morning stiffness:
(in and around joints, lasting at least 1 hour before max improvement)

2) Arthritis of 3 or more joint areas:
(simultaneously has soft tissue swelling or fluid observed by clinician)

3) Arthritis of hand joints
(minimum of 1 area swollen in wrist, MCP, or PIP joints)

4) Symmetric arthritis

5) Rheumatoid nodules
(subcutaneous nodules, over bony prominences or extensor sufaces or in juxta articular regions)

6) Serum rheumatoid factor
(blood test; not diagnostic)

7) Radiographic changes
(erosion and loss of bone density