RHUMETOID ARTHRITIS Flashcards
What are 5 classic radiographic appearances of Rheumatoid arthritis ?
1) Soft tissue swelling.
2) Juxta articular osteopenia.
3) Joint space narrowing
4) Marginal erosions.
Subluxations and dislocations.
Where does RA tend to happen ?
Wrists
Metacarpal phalangeal joint.
Tarsal metatarsal joints.
What is the earliest signs of RA, even before bony erosions are present ?
Osteoporosis. (juxta articular)
What are the characteristics of a later stage of RA ?
SUBLUXATIONS/ DISLOCATIONS
REMODELLING OF THE JOINT
SIGNIFICANT DAMAGE TO THE JOINT CAN RESULT IN SECONDARY OA.
Where is the classic site for RA in the C SPINE ?
Atlanto axial joint.
What is RA ?
This is the most common type of inflammatory arthritis of unknown cause.
What tissue types does RA predominantly affect ?
Synovial tissues
What is the patient presentation for RA ?
Pain, stiffness of the affected joint.
What would blood results Positive for RA show ?
Positive rheumatoid factor.
Explain the pathophysiology of RA 1-4 ?
1) An antigen reaches the synovial tissue causing a local immune response.
2) This causes Synovitis. (inflammation of the synovium).
3) This leads to Synovial hyperplasia (Inflammation of the synovium) and the formation of pannus.
4) The edge of the pannus contain cells that produce protease which destroys cartilage and osteoclasts are formed which destroy subchondral bone. (EROSIONS)
What are the first radiographic signs of RA ?
Soft tissue swelling and Osteopenia.
What joints do Rheumatoid arthritis affect?
Any synovial lined joint.
In the hands where does it predominantly occur ?
It occurs at the proximal joints and is bilateral and symmetrical.
What does Rheumatoid arthritis look like in the hip ?
the femoral head migrates axially. In OA is migrates superolateral.
What does RA look like in the shoulder ?
The humeral head is high riding. This is also a finding in Rotator cuff degeneration and CPPD.
