Rheumatoid arthritis

Question 1

Causes of Rheumatoid arthritis

Answer 1

Autoimmune

Question 2

Epidmiology of Rheumatoid arthritis

Answer 2

More common in women

seen in adults of all ages

Question 3

Commonest joints affected in Rheumatoid arthritis

Answer 3

MCP and PIP joints never DIP

Question 4

Presentation of Rheumatoid arthritis

Answer 4

Morning stiffness improving with use

Bilateral symptoms

Systemic upset

Question 5

Investigations of Rheumatoid arthritis

Answer 5

Rheumatoid factor (RhF) - positive in 70%

anticyclic citrullinated peptied antibodies ACPA highly specific for RA 98%

Anaemia of chronic disease

platelets ESR CRP all raised

Plain film:

Loss of joint space
Juxta-articular osteoporosis
Periarticular erosions
Subluxation

MRI and USS better for detecting synovitis

Question 6

Where is the MCP joint

Answer 6

metacarpophalangeal joints (MCP)

it is between metacarpal joints and proximal phalanges