Rheumatoid Arthritis Flashcards
Define Rheumatoid ARthritis
an autoimmune condition leading to inappropriate immune system activity causing synovial and connective tissue inflammation
Patholgy RA. Cause?
Chronic inflammation growth of tissue (pannus) loss of bone and cartilage (bone revrsible, cartilage not)
Triggered by genetics and by a “stochastic” event
Consequences of inflammation
Loss of cartilage
Formation of scar tissue
Ligament laxity
Tendon contractures – joint to twist into locked position
RA Symptoms
Symmetrical joint pain and stiffness >6 weeks
Muscle pain
May have fatigue, weakness, low-grade fever, appetite decrease
Joint tenderness with warmth and swelling over affected joints
Rheumatoid nodules may develop (collection of fibrous scar tissue) – not painful unless effecting a nerve
Most commonly a rapid onset starting in peripheral joints
Difference between RA and Osteo
Joint Damage
Occurs early in the course of RA
30% of patients have bone erosion at time of diagnosis
Damage is irreversible
Functional loss follows
RA can also effect the….
Blood Vessels
Lungs
Eyes
Heart
Muscle
Bone
Skin
Hematologic abnormalities
Blood vessels
Rheumatoid vasculitis
Occurs with severe, long-standing RA
Leads to substantial morbidity
Can affect any blood vessel
Symptoms experienced depend on affected vessels
Only treatment: Aggressive treatment of RA itself
Lungs
Pleuritis, pleural effusion, fibrosis, pulmonary nodules
Drugs used to treat RA may also impact lung function
Eyes
Episcleritis, scleritis, uveitis and iritis
Painful, visual acuity loss
Heart
Pericarditis, myocarditis
Increase risk of CAD, heart failure and atrial fibrillation
Muscle
Generalized weakness and pain
From synovial inflammation, myositis, vasculitis
Steroid-induced
Bone
Osteopenia common
Local bone loss around affected joints
Skin
Rheumatoid nodules
Ulcers
Steroid-induced changes
Hematological
Anemia – not iron; anemia of. Chronic dx (chronic inflammation) – treat the inflammatory pathway