Rheumatology: Rheumatoid and Osteoarthritis Flashcards
What antibody is most often found in rheumatoid arthritis?
Anti CCP
What are the 4 signs you see on the X Ray of an osteoarthritis joint?
Loss of joint space
Osteophyte formation
Subchondral sclerosis
Subchondarl cysts
What symtpoms are associated with inflammatory arthropathies?
Pain + swelling Morning stiffness Improvement with exercise Synovitis Raised inflammatory markers (CRP and PV) Extra articular symptoms
Is RA symmetrical or non symmetrical?
Symmetrical
What is the pathogenesis of RA?
Immune destruction of synovium
What joints are affected in RA?
MCPs and PIPs
Not DIPs
What can be a lifethreatening manifestation of RA?
Involvement of the cervicals pine can cause atlanto axial subluxation which can result in cervical c or compression
What can happen to the lungs in RA?
Pleural effusions
Interstitial fibrosis
Pulmonary nodules
What extra articular features can be seen in RA?
Rheumatoid nodules on the skin
Keratoconjunctivitis sicca
Uveitis
Episcleritis
What will an US of RA show?
Synovial inflammation
What is the first line DMARD used in RA?
Methotrexate
Next line would be sulphasalazine, hydroxycholoroquine and leflunomide
How is disease activity measured in RA?
DAS 28 score. This comprises of 4 domain includign
1. Tender joint count
2. Swollen joint count
3. CRP/ESR
4. Patients own assessment of disease activity
The patients DAS 28 score much be more than 5.1 to be eligable for biologic therapy
If DMARDs are not working what is the next line treatment in RA?
Biologics - Anti TNF
What joints in the hand are affected by rheumatoid arthritis?
MCPS and PIPs
When should DMARDs be started in rheumatoid arthritis?
Within 3 months of symptom onset
