Rheumatoid Arthritis: Background Info

Question 1

RA is a progressive ______ (inflammation of the synovial membrane) of the ______ joints that can lead to destruction of ligament, tendon, cartilage, and bone.
Uneven distribution of biomechanical forces on weakened
ligaments and tendons can lead to permanent deformities of the joint

Answer 1

synovitis

diarthrodial

Question 2

Joint swelling from excessive ___ combined with enlargement of the synovium and thickening of the joint capsule leads to weakened joint capsules and distended tendons and ligaments.

Answer 2

synovial fluid

Question 3

With symmetric polyarticular presentation of RA, what are the most commonly affected joints?

Answer 3

PIP, MCP, All thumb joints, wrist, elbow, ankle, metatarsophalangeal. temporamandibular, hips, knees, shoulder, and cervical spine

Question 4

Common symptoms of RA include:

Answer 4

pain, redness, warmth, tenderness, morning stiffness, ROM limitations, muscle weakness, weight loss, malaise, fatigue, and depression

Question 5

In RA, a systemic disease, some secondary extra-articular complications, may occur in which body systems?

Answer 5

cardiovascular, ocular, respiratory, gastrointestinal, renal, and neurological

Question 6

Boutonniere deformity:

Answer 6

flexion of the PIP joint and hyperextension of the DIP joint

Question 7

Swan neck deformity:

Answer 7

hyperextension of the PIP joint and flexion of the DIP joint

Question 8

Mallet finger:

Answer 8

flexion of the DIP joint

Question 9

4. Ulnar drift:

Answer 9

radial deviation of the wrist and ulnar deviation of the MCP joints (sometimes called a
zigzag deformity)

Question 10

Mutilans deformity:

Answer 10

characterized by very floppy joints with shortened bones and redundant skin; caused by reabsorption of bone ends; most common in the MCP, PIP, radiocarpal, or radioulnar
joints

Question 11

Acute phase of RA:

2.

Answer 11

pain and tenderness at rest that increases with movement; limited ROM; overall stiffness; gel phenomenon (inability to move joints after rest); weakness; tingling or numbness; hot, red joints;
cold, sweaty hands; low endurance; weight loss or decreased appetite; fever

Question 12

Subacute phase of RA

Answer 12

reduced pain and tenderness; morning stiffness; limited movement; tingling or numbness; pink, warm joints; low endurance; weakness; gel phenomenon; weight loss or decreased appetite; mild fever

Question 13

Chronic–active phase of RA

Answer 13

low-grade inflammation, decreased ROM, less tingling, pain and tenderness primarily with movement, low endurance

Question 14

Chronic–inactive phase of RA

Answer 14

No signs of inflammation, low endurance, pain from stiffness and weakened
joints, morning stiffness primarily related to disuse, limited ROM, weakness and muscle atrophy,
contractures

Question 15

Stage I RA

Answer 15

no destructive changes on X ray; possible presence of osteoporosis

Question 16

Stage II RA

Answer 16

radiographic evidence of osteoporosis; possible slight subchondral bone destruction and possible presence of slight cartilage destruction; no joint deformity (possible limited ROM); adjacent muscle atrophy; possible presence of extra-articular soft-tissue lesions

Question 17

Stage III RA

Answer 17

Severe: radiographic evidence of osteoporosis; cartilage and bone destruction; joint deformity; extensive muscle atrophy; possible presence of extra-articular soft-tissue lesions

Question 18

Stage IV RA

Answer 18

terminal: fibrous or bony ankylosis in addition to Stage III