Rheumatoid Arthritis Flashcards
What is rheumatoid arthritis?
Symmetrical autoimmune destruction of the synovium due to damage from inflammation to the cartilage, tendons and ligaments
What are risk factors for RA?
Young, female, FH, other autoimmune diseases
What are symptoms of RA?
Painful, swollen, stiff joints for more than an hour in the morning, better with movement
What are signs of RA?
Swan neck thumb, ulnar deviation, boutonniere deformity, Z thumb
What are the most common extra-articular manifestations?
Rheumatoid nodules, Sjogren’s, Anaemia of chronic disease, Keratoconjunctivitis sicca, pleural disease (usually asymptomatic), Pericarditis (symptomatic uncommon)
What is keratoconjunctivitis sicca?
Dry eye syndrome
What antibody test is highly specific for RA?
Anticyclic citrullinated peptide antibody (anti-CCP)
What blood investigations would you do?
Anti-CCP, rheumatoid factor, raised ESR/CRP
What will X-rays show?
LESS Loss of joint space Erosion Soft tissue swelling Soft bones
What score can you use to measure disease activity?
28-joint disease activity score
How would you manage RA?
Ibuprofen/NSAIDs, steroids, methotrexate, rituximab
What non-pharmalogical managements are there?
Specialist physio and occupational therapy
What is the purpose of surgery?
Pain relief, improve function, prevent deformity
What is a potential side effect of DMARDs and how can you monitor this?
Immunosuppression, monitor with regular FBCs and LFTs
What are potential complications of RA?
Cervical spinal cord compression, lung involvement
