Rheumatoid arthritis clinical features Flashcards
What are the 7 classifications of rheumatoid arthritis?
- Morning stiffness
- Arthritis of 3 or more joints
- Arthritis of hand joints
- Symmetric arthritis
- Rheumatoid nodules
- Serum rheumatoid factor
- Radiographic changes
What is morning stiffness (lel)
Morning stiffness in and around joints lasting at least an hour
What are rheumatoid nodules?
Subcutaneous nodules over bony prominences, extensor surfaces, or in juxtaarticular regions
What radiographic changes may occur in rheumatoid arthritis?
Erosions
Unequivocal bony decalcifications
What is the prevalence of rheumatoid arthritis?
Around 1% of the population
What is the incidence of rheumatoid arthritis?
Approximately 200 new cases per year
What is the male:female ratio of incidence?
1:3
What is the peak age of onset?
4th/5th decade
What investigations can be done into rheumatoid arthritis?
Immunology - rheumatoid factor, Anti Cyclic Citrullinated Antibodies
X-Rays
What are symptoms of rheumatoid arthritis?
Pain Stiffness Immobility Poor function Systemic symptoms
What are clinical signs of arthritis?
Swelling Tenderness Limitation of movement Redness Heat
What are non-specific systemic features of rheumatoid arthritis?
Fatigue
Weight loss
Anaemia
What are specific systemic features of rheumatoid arthritis?
Eyes Lungs Nerves Skin Kidneys
What are long term systemic features of rheumatoid arthritis?
CVS
Malignancy
How is rheumatoid arthritis assessed?
Disease activity score
DAS<2.4 = clinical remission
DAS>5.1 = Eligibility for biologic therapy
What is the general outcome for rheumatoid arthritis?
75% of cases diagnosed during working life
Around 1/3 will stop work within 2 years
Around half will be unable to work within 10 years
What are the 4 main categories of treatment for rheumatoid arthritis?
Medicines
Injections
Therapies
Surgery
What are the categories of therapeutics for rheumatoid arthritis?
NSAIDs
Disease Modifying Anti-Rheumatic Drugs
Biologics
Corticosteroids
What Disease Modifying Anti Rheumatic Drugs are currently used?
Methotrexate
Sulfasalazine
Hydroxychloroquine
Leflunomide
What is the general approach to management of rheumatoid arthritis?
Early and aggressive intervention
Suppression of inflammation will prevent joint damage and disability
What are biologics?
Large complex proteins which target key aspects of inflammatory cascade
How are biologics delivered to the patient?
Parenterally
