RA - Pathogenesis + Dx workup Flashcards

1
Q

The first change seen is rheumatoid ?, with a ?synovium showing a ? pattern and ? infiltration.

This leads to an exudative ? within the joint.
o This presents clinically as a ?, ? joint.

As the disease progresses, vascular granulation tissue (pannus: formed by
? and ?) grows from the peripheries ?,
destroying articular ?.

A
synovitis
swollen
villous
neutrophil
effusion
boggy
swollen
osteoclasts
macrophages
inwards
cartilage
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2
Q

This inflammatory ? also causes focal destruction of bone, causing
‘?’ as seen on radiographs.
o Clinically this can lead to joint ?.
In long-standing disease, the ? cartilage may be destroyed and replaced by fibrous pannus, leading to secondary ? changes.

Morning stiffness in RA / the inflammatory arthropathies is thought to be either due
to the ? ? (abnormality seen in rheumacy), or the build up of ? ? during non-activity.

A
pannus
erosions
deformities
whole
osteoarthritic
cortisol trough
inflam mediators
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3
Q

Dx
Bloods

o FBC: ? and ? in acute inflammatory phase,
? anaemia of chronic disease.
o ?/?: elevated in active disease.
o Rheumatoid Factor (RF): elevation in ?%, but non-specific.
o Anti-?: more specific, rises ? clinical disease by several ?
o ANA: if suspecting ? ?disease, however raised in 30%.
stands for -> • Anti-? ?.

A
leukocytosis
thrombocytosis
normocytic
esr/crp
70
ccp
predate
years
conn tiss
nuclear antibody
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4
Q

Dx
XR

o Early findings: soft tissue ? around the ???Js and ???Js.
• ? usually spared (c.f. OA).
o Uniform joint ? ?
o Juxta-articular ?: can become more diffuse as disease progresses.
o Periarticular ?: form at extremities of the joint where the ? cartilage ends, as it is invaded by ?.
o ? / dislocation may also be seen.

A
swelling
pip + mcp
dipjs
space narrowing
osteopenia
erosions
hyaline
pannus
subluxation
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