Rheumatoid Arthritis (RA) Flashcards
1
Q
Describe rheumatoid arthritis
A
- a chronic systemic inflammatory disease
- presents with articular & extra-articular findings
- results in gradual destruction of joint tissues
- often significant deformity & disability
- affects joints symmetrically
2
Q
What are the most commonly affected joints for rheumatoid arthritis
A
- wrists
- fingers
- knees
- ankles
- feet
3
Q
What are the risk factors for rheumatoid arthritis
A
- hormones
- infection
- genetics
- environment
-associated with autoimmune thyroid & rheumatic diseases
4
Q
Who is the at risk population for rheumatoid arthritis
A
- affects all races equally
- women are 3x more likely then men
- 2nd most prevalent form of arthritis
- onset at any age but most common from 30-60 years old
5
Q
Define pannus
A
- the thickened synovium with destructive vascular granulation tissue
- destroys collagen, cartilage, & subchondral bone
6
Q
Pathogenesis of rheumatoid arthritis
A
- joint inflammation due to presence of immune cells in synovial fluid
- cells in synovial lining multiply, leukocytes increase causing edema & synovitis
- protein destroying enzymes are released causing articular cartilage destruction & synovial hyperplasia
- swelling, joint pain, deformity, joint instability, & altered biomechanics result
7
Q
Clinical characteristics of rheumatoid arthritis & symptoms
A
- begins slowly, cartilage degradation, ligamentous laxity, synovial effusion, & erosion
- Symptoms: fatigue, weight loss, diffuse musculoskeletal pain, reconditioning, & depression
8
Q
Joints symptoms of rheumatoid arthritis
A
- instability, deformity, & laxity
- MCP & IP early
- morning stiffness >1 hour
- joints may feel warm, tender, edematous, & stiff
- loss of ROM & function
9
Q
Hand impairments related to rheumatoid arthritis
A
- swan neck deformity
- boutonniere deformity
- ulnar drift
- thumb MP flexion with IP hyperextension
10
Q
Describe swan neck deformity
A
- MCP flexion
- PIP hyperextension
- DIP flexion
11
Q
Knee impairment related to rheumatoid arthritis
A
- genu valgus
- baker’s cyst
12
Q
Ankle/foot impairments related to rheumatoid arthritis
A
- pronation
- hallux valgus
- hammer toes
- claw toes
13
Q
Extra-articular manifestations of rheumatoid arthritis
A
- synovitis, bursitis, tendonitis, fasciitis, neuritis, & vasculitis
- rheumatoid nodules: surfaces with repeated mechanical pressure
- increased risk for myocardial infarction & congested heart failure
- slogan syndrome
- depression
- sleep disorders
14
Q
Diagnosis of rheumatoid arthritis
A
- American college of rheumatology: synovitis in at least 1 joint & a score of 6 or more
- serum rheumatoid factor
- synovial fluid analysis
- C-reactive protein
- X-ray
- MRI
- ultrasound
15
Q
Synovial fluid lab testing results with rheumatoid arthritis
A
- decreased volume
- increased white blood cells
- increases protein & protein antibodies