Rheumatoid Arthritis Flashcards
what is rheumatoid arthritis?
a chronic systemic inflammatory disease characterised by potentially deforming symmetrical polyarthritis & extra-articular features
what is the aetiology of RA?
genetic susceptibility
environmental triggers
cigarette smoking
infective?
what happens to the joint in RA?
- thickened invasive synovium
- more & thinner synovial fluid
what does the thickened invasive synovium release?
all sorts of cytokines into the synovial space
describe the pathology of the synovium in RA
becomes laden with macrophages, fibroblasts & multi-nucleated giant cells (resemble osteoclasts)
describe the pathology of the synovial membrane/pannus in RA
exapnds, actively invade & erodes surrounding bone & cartilage
where else in the surrounding of the joint can be affected by synovium changes
tendon sheath
what are the articular symptoms?
- joint pain
- stiffness, especially in the morning
- joint swelling due to the pannus
- general symptoms e.g. malaise, fatigue
what signs are you likely to see in RA?
- swelling
- tenderness
- reduced range of movement
- deformities??
- muscle wasting??
- nodules
describe a swan neck deformity
flexion at the DIPJ & hyperextensionn at PIPJ
describe boutonneire’s deformity
hyperextensoin at DIPJ & flexion at PIPJ
name the deformities commonly found in the hands
- ulnar deviation
- z-shaped thumb
- swan neck
- boutonneires
- dorsal wrist subluxation
what are the common manifestations in the eyes
- dry eye
- inflammation -> fibrosis of the lateral glands
- reduced tear production
- scleritis -> rupture
scleritis
inflammation of the tissue covering the sclera
what are the common lung manifestation
- pulmonary fibrosis
- pleural effusions
- interstitial lung disease
