Week 2 - Rheumatoid Arthritis Flashcards
what is the most prevalent seropositive arthropathy?
rheumatoid arthritis (RA)
what is RA?
autoimmune inflammatory symmetrical polyarthropathy which commonly affects the small joints of the hands and feet
where does RA affect?
usually small joints of the hands and feet but can affect larger joints (knees etc) as disease progresses
who is more commonly affected by RA?
women
most commonly peaks between 35-50
what increased risk of RA?
genetic factors account for 50% of risk
first degree relatives have 2-3X higher risk
describe the pathogenesis of RA?
immune response is initiated against synovium
inflammatory pannus forms which then attacks and denudes articular cartilage leading to joint destruction
tendon ruptures and soft tissue damage can occur leading to joint instability and subluxation
what can trigger RA?
smoking
infection
trauma
stress
how is RA diagnosed?
clinical presentation
radiography
serological analysis
what are the clinical features of RA?
symmetrical synovitis (doughy swelling) pain morning stiffness (>30 mins - 1 hr) sparing of DIP joints in hand
what are the early features of RA?
small joint synovitis
wrists, MCPs and PIPs affected
late features of RA?
deformities of the joint if aggressive or untreated
how can RA affect the spine?
atlanto-axial subluxation can be seen in longstanding disease which can result in cervical cord compression
how can RA affect the skin?
can cause rheumatoid nodules in 25% of RA patients
usually on extensor surfaces or sites of frequent mechanical irritation
how can RA affect the lungs?
pleural effusions
interstitial fibrosis
pulmonary nodules
how can RA affect the heart?
increases cardiovascular morbidity and mortality