Rheumatoid arthritis Flashcards
Define RA
Chronic systemic inflammatory disease characterised by symmetrical deforming peripheral polyartheritis
What joints does RA usually affect?
small joints of hand e.g. MCP, PIP, MTP
later affects larger joints
What are risk factors for RA?
Female, HLADR4, family history, smoking
What are clinical features of RA?
Joint pain redness swelling and deformity
Morning stiffness
Fatigue, weakness, weight loss
Extra-articular: nodules in lungs and on skin and heart, scleritis, vasculitis
What deformities are seen in RA?
Swan neck
Boutonniere/Z thumb
Ulnar deviation
Piano Key ulnar head
What investigations in RA
Bloods: RF and anti-CCP. CRP and ESR
X-ray showing erosions
Can do US to see synovitis
What differentials for RA?
OA, SLA, psoriasis, gout, septic
What are 4 components in RA diagnostic criteria?
Joint involvement
Serology
Acute phase reactants
Duration of Sx
What is treatment of RA?
DMARD, steroid, NSAID
+ biologic if mod-severe
Physio and OT
What different biologics in RA?
Anti TNF, CD20, IL6, also CTLA4
What are complications of RA?
Work disability, joint replacement, ILD, CAD
What scoring system in RA?
DAS28
How should flares of RA be trated?
steroids
