Rheumatoid Arthritis CAT

Question 1

What is rheumatoid arthritis?

Answer 1

• Systemic autoimmune disorder of connective tissue
• Characterized by chronic inflammation in synovial membranes, tendon sheaths, and articular cartilage

Question 2

Which joints are most likely to be affected by RA?

Answer 2

Smaller peripheral joints are likely to be first affected, but all connective tissue may be involved

Question 3

What percentage of patients w/ RA possess a positive rheumatoid factor (RF)?

Answer 3

~80%

Question 4

Incidence of RA by sex

Answer 4

Female > male

Question 5

Clinical presentation for RA

Answer 5

• Periods of exacerbations
• Diagnosed b/t 30-50 y/o
• Sudden or gradual onset
• Fatigue, bilateral involvement, tenderness of smaller joints, low-grade fever
• Pain w/ movement, stiffness (prolonged morning stiffness)
• Progresses to larger joints

Question 6

Late-stage RA

Answer 6

• Heart can be affected
• Deformities, subluxations, and contractures can occur

Question 7

Labs/imaging for RA

Answer 7

• Blood work: RF, WBC, erythrocyte sedimentation rate (ESR), hemoglobin, and hematocrit
• X-ray for joint space and extent of decalcification

Question 8

Medical management of RA

Answer 8

• Focus on pain relief, edema reduction, preserve joint integrity
• NSAIDs, corticosteroids, disease-modifying meds (methotrexate)

Question 9

PT management of RA in acute phase

Answer 9

• Pt education on pain relief, relaxation, positioning, joint protection, splinting, energy conservation, body mechanics
• Massage, hydrotherapy, hot pack, paraffin, cold, isometrics, AD

Question 10

PT management of RA in chronic phase

Answer 10

• Improve overall functional capacity, endurance, and strength
• Low-impact conditioning
• Gentle stretching, aggressive is contraindicated