Multi-system - Rheumatoid Arthritis Flashcards
(16 cards)
PIP joint flexed and DIP hyperextended
Boutonnière deformity
MCP joint flexed, PIP joint hyperextended, and DIP joint flexed
Swan-neck contractures
Hyperextension of the interphalangeal joint of the thumb with fixed flexion of the MCP joint (Z deformity of the thumb)
Hitchhiker thumb deformity
Most specific autoantibody for rheumatoid arthritis
Anti-citrulinnated peptide antibodies (ACPA)
This positive autoantibody is associated with an aggressive disease course
Rheumatoid factor (RF)
Typically elevated in connective tissue disorders, may also be found in autoimmune hepatitis and vasculitides
Antinuclear antibody (ANA)
Painful compression of hands or feet at the level of the MCP joint
Gaenslen squeeze test
Non-tender firm, subcutaneous swellings (2mm-5cm) commonly found in areas exposure to higher pressure (extensor forearm or bony prominence)
Rheumatoid nodules
Rheumatoid pulmonary nodules that may be accompanied by fibrosis and pneumoconiosis
Caplan syndrome
A potentially life-threatening complication of rheumatoid arthritis caused by the inflammatory destruction of the ligaments affecting the atlantoaxial joint and the intervertebral joints
Atlantoaxial subluxation
Clinical features of atlantoaxial subluxation
- pain and stiffness of the neck (typically early-morning neck pain at rest)
- cervical radiculopathy with peripheral paresthesias
Diagnostic test for atlantoaxial subluxation
Extension and Flexion X-rays of the cervical spine
Severe subtype of rheumatoid arthritis characterized by a triad of arthritis, neutropenia and splenomegaly
Felty syndrome
Diagnosis of rheumatoid arthritis
Clinical diagnosis
Genetic predisposition for rheumatoid arthritis
HLA-DR4, HLA-DR1
Hallmark clinical manifestation
- polyarthralgia with symmetrical pain and swelling
- DIP joints are spared
- MCP, PIP joints are affected
- morning stiffness ( >30 mins) that improves with activity
