Rheumatoid Arthritis

Question 1

Rheumatic Disease - Definition

Answer 1

Systemic disease affecting any and all body systems. Characterized by exacerbation and remission.

Question 2

Rheumatoid Arthritis - Definition

Answer 2

Chronic systemic inflammatory disease affecting synovial lining of joints and other connective tissue.

Question 3

Rheumatoid Arthritis - Articular Findings

Answer 3

Inflammation, swelling and pain in several joints, bilateral.

Question 4

Rheumatoid Arthritis - Extra-articular Findings (8)

Answer 4

Cardiovascular, pulmonary and gastrointestinal systems may be involved.
Affects bone, skin, heart and lungs.
Eye lesions.

Question 5

Rheumatoid Arthritis - Risk Factors (6)

Answer 5

Higher age
Female
Smoking
Decaffeinated coffee
Thyroid disease

Question 6

Rheumatoid Arthritis - Cause

Answer 6

Unknown, possibly genetics or environmental factors.

Question 7

Rheumatoid Arthritis - Pathogenesis

Answer 7

Hypertrophic joint -> thickened synovium.
Uncontrolled neovascularization -> Pannus tissue formation (vascular granulation tissue - unhealthy).

Question 8

Rheumatoid Arthritis - Most Frequently Involved Joints (4)

Answer 8

Wrists, fingers, hands and feet.

Question 9

Rheumatoid Arthritis - Manifestation - Subjective (6)

Answer 9

Fatigue, weight loss, weakness, diffuse MSK pain, deconditioning, depression.

Question 10

Rheumatoid Arthritis - Manifestation - Objective (7)

Answer 10

Multiple joints affected, symmetrical, edema, warmth, pain, morning stiffness > 30 min, joint deformities, RA nodules.

Question 11

Rheumatoid Arthritis - Rehab (6)

Answer 11

Multidisciplinary and long-term planning. Aims to:
- maintain state of remission
- Reduce pain
- Maintain mobility
- Minimize stiffness, edema and joint destruction.
- Restore function
- Delay and reduce disability

Question 12

Rheumatoid Arthritis - Assessment (2)

Answer 12

Functional
- Overall assessment of ADLs and activities noted limited by patient.
- Foot assessment: deformities, uneven weight bearing, shoes, assistive device.

Question 13

Rheumatoid Arthritis - Education (2)

Answer 13

Self management strategies: Pacing, joint protection, symptom monitoring.
Unload joints and reduce mechanical stress.

Question 14

Rheumatoid Arthritis - Exercise Interventions (4)

Answer 14

Aim to prevent contractures, improve strength, increase cardiorespiratory and aerobic conditioning.
- Functional strength training
- Aerobic and resistance exercise
- Balance, coordination, posture, ROM exercises
- Hydrotherapy
30 min of moderate exercise 4-5x per week.