Rhuematoid Arthritis Flashcards
What is rheumatoid Arthritis?
A systematic inflammatory disease which attacks the joint by producing a proliferative synovitis and leads to the destruction of articular cartilage and underlying bone
starts as an autoimmune response- activated by the B cells against which make antibodies against the bodies own cells and tissues
Changes in the synovial membrane
increased WBCs lead to angiogenesis
Thickening of the membrane which creates a destructive granulation tissue called a pannus
pannus projects into the joint space by the junction of the articular cartilage and subchondral bone
Pannus invasion
pannus grows from the joint margins across the articular surfaces
This blocks the articular cartilage from receiving nutrition from the synovial fluid
cytokines released
they damages the chondrocytes
This results in the thinning of the cartilage and exposure of the underlying bone
Pathology of RA
Insidious onset but may also have an acute presentation
Associated with systematic symptoms
in early RA it takes place in the synovial tissue leading to painful joints
Symptoms
symmetric joint pain swelling of peripheral joints morning joint stiffness of variable duration fatigue depression weight loss disturbed sleep flulike symptoms
Presentation of RA
begins as an inflammatory thropathy Onset is variable with 3 types of patterns: - poly arthritis mono arthritis episodic arthritis can be rapid or slow
Joint Symptoms
Pain Stiffness Insidious onset Joint Swelling Pain with movement Deformity joint temperature increase
Use of blood tests
Used to measure inflammation
a high c reactive protein means that there is inflammation
erythrocyte sedimentation rate looks at where RBCs settle in the liquid
Treatment
Drug management: steroids
Surgical management: to relieve pain, improve function and restore stability. Arthrodesis
Physiotherapy: relief of pain, prevention of deformity
maintenance of optimum function
