Rad L4: RA; JRA Flashcards Preview

CHI303:clinical Science And Diagnosis > Rad L4: RA; JRA > Flashcards

Flashcards in Rad L4: RA; JRA Deck (6):
1

Rheumatoid Arthritis:

Definition

What is affected

Distribution

  • Connective tissue disorder targets synovial joints
  • Affects hands, feet, C-spine m.c.
  • Bilateral symmetric distribution
  • Other systems involved: heart, lung, vessels, nervous system, eyes

2

Clincal Features of Rheumatoid Arthritis

  • Onset 20-60 y/o, peak 40-50
  • F:M, 3:1  after 40 1:1
  • Insidious onset, with articular pain, tenderness, swelling, stiffness
  • C-spine is affected up to 80% (late)
  • Fatigue, malaise, muscle weakness, fever, tendon rupture, bursitis
  • Firm non-tender nodules in 20% of patients: forearm, knees, ankles, hands
  • Haygarth’s nodes: soft tissue swelling adjacent to the MCP
  • Prognosis unpredictable –remissions and exacerbations –progressive deformity and disability

3

What leb tests whould you request for a patient with suspected RA?

  • ESR/C-RP paralleling disease activity
  • 70% of patients will have RF, but it is not specific

4

What are some pathologic features of RA?

Joints involved

Pannus

 

  • hands, wrist, feet, knee, hip and spine
  • Synovitis, oedema, effusion, periarticular oedema, juxta-articular hyperemia.
  • Pannus - vascular granulation tissue spreads over interarticular surface of bone and cartilage. 
  • “Bare area”: pannus leads to erosions of the bone 
  • Hyaline cartilage will erode due to chondrolytic enzyme
  • Pannus fills the joint, may progress to fibrosis, and rarely, bony ankylosis

5

General Information JRA:

Age

Potential associated causes

blood pathology

  • Seropositive (10%) seronegative (stills disease)
  • onset <16yrs
  • changes mainly revolve around growth disturbances, joint disfunction, corticosteroid use, inactivity
  • ESR elevated, anemias, leukocytosis

6

Radiographic features of JRA

  • Soft tissue swelling
  • Osteoporosis
  • Periostitis
  • Uniform loss of joint space- late
  • Articular erosions- late
  • Growth disturbances – increase or decrease
  • Growth arrest lines
  • Ankylosis common in hands and feet,