Rheumatology Flashcards
(21 cards)
What is rheumatology?
Medical speciality in connection with arthritis and other related conditions
What is arthritis?
Inflammation of a joint or joints
List the symptoms of arthritis?
Pain Stiffness Swelling Functional Impairment Systemic Symptpms
What are the signs of arthritis?
Tenderness Swelling Restriction of Movement Heat Redness Systemic Features
List some rheumatic disease conditions
RA Sero negative arthritis Crystal Arthritis Connective Tissue Diseases Systemic Vasculitis Bone Disease Osteoarthritis
What are the functions of synovium?
- Maintenance of intact tissue surface
- Lubrication of cartilage
- Control of synovial fluid volume and coposition (hyaluronan, lubricin)
- Nutrition of chondrocytes within joints
What signs may be seen in a rheumatoid joint?
Inflamed synovium spreading across joint surface
Thinning of cartilage
Inflamed tendon sheath
Erosion into corner of bone
Which bones are primarily affected in RA?
Small joints of hands and feet
What is the definition of RA?
Chronic symmetric polyarticular inflammatory joint disease
What are the characteristics of the rheumatoid synovitis (pannus) in RA?
- Inflammatory cell infiltration
- Synoviocyte proliferation
- Neoangiogenesis
What type of inflammatory cells are found in the synovial fluid in RA?
Neutrophils
Particularly during acute flares
What type of antibodies are associated with RA?
Rheumatoid Factors
Anti-citrullinated protein
(Recognise joint antigens or systemic antigens)
What infectious agents are associated with RA?
Viruses (EBV, CMV) E. Coli Mycoplasma Periodontal disease (Porphyromonas gingivalis) Microbiome (gut microbes)
What cells infiltrate in synovitis?
T cells (CD4+)
B cells
Macrophages
Plasma cells
What enhances neoangiogenesis in RA?
Hypoxic conditions and angiogenic factors
What mediates bone destruction in RA?
Osteoclasts
When are symptoms worst in Rheumatoid Arthritis?
Morning
Who may be involved in Early RA Multidiscipliary Care?
Rheumatology Specialist Nurse Rheumatology Occupational Therapist Rheumatology Physiotherapist Pharmacist Clinical Psychologist Podiatrist Orthotics
What are some potential complications of RA?
Orthopaedic Intervention
Extra-articular involvement (Rhumatic nodules, interstitial lung disease, vasculitis)
CV Risk
Socio-economic Impacts
What are some potential complications of orthopaedic intervention in RA?
Chronic synovitis Mechanical deformities Secondary osteoarthritis Poor function Pain
What sort of adaptations are available to help with functional impairments?
Special adaptive cutlery Special footwear Walking aids Use of wheelchair for outdoors Supportive family Care package
