Rheumatoid Arthritis Flashcards
What is rheumatoid arthritis?
chronic inflammatory systemic disease of symmetrical deforming polyarthritis + extra-articular manifestations
Describe the aetiology of rheumatoid arthritis
AI disease
UNKNOWN cause
Associated with other AI diseases (e.g. Sjogren’s)
What are the HLA associations of rheumatoid arthritis?
HLA-DR1
HLA-DR4
Describe the epidemiology of rheumatoid arthritis
COMMON
1% of general population
F > M
Peak incidence: 30-50 yrs
Describe the onset of rheumatoid arthritis
GRADUAL
List 3 symptoms of rheumatoid arthritis
Joint pain
Swelling
Impaired function
Give 3 systemic symptoms that may arise in rheumatoid arthritis
Fever
Fatigue
Weight loss
Describe the pain pattern in rheumatoid arthritis
Morning stiffness
Usually affects peripheral joints symmetrically
List 4 early signs of rheumatoid arthritis
Spindling of fingers
Swelling of MCP + PIP joints
Warm, tender joints
Reduction in range of movement
Which site is most commonly affected in rheumatoid arthritis?
HANDS
Give 6 signs of late rheumatoid arthritis
Symmetrical deforming arthropathy
Ulnar deviation of fingers due to subluxation of MCP joints
Radial deviation of the wrist
Z deformity of the thumb
Trigger finger (inability to straighten finger, tendon nodule palpable)
Wasting of small muscles of the hand
What are rheumatoid nodules?
firm subcutaneous nodules (found on elbows, ulnar margin, palms + over extensor tendons)
Name 2 specific deformities seen in rheumatoid arthritis
Swan neck: PIP hyperextension + DIP flexion
Boutonniere: PIP flexion + DIP hyperextension.
Describe the bloods in rheumatoid arthritis
FBC: low Hb (ACD), high platelets
High ESR + CRP
Rheumatoid factor (+ve in 70%)
Anticyclic citrullinated peptide antibodies (anti-ccp) (v high specificity)
What is the presence of rheumatoid factor associated with?
Rheumatoid nodules + extra-articular manifestations
