Rheumatoid Arthritis 2
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- How is rheumatoid arthritis defined?
- A diffuse, chronic, systemic inflammation of connective tissue.
- Rheumatoid arthritis selectivity targets what tissue?
- Synovial tissue
- Rheumatoid arthritis may affect what other tissues?
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- Muscle
- Bone
- Heart
- Lungs
- Blood vessels - Rheumatoid arthritis affects the joint unilaterally. True or False?
- False. It effects joints bilaterally.
- In 50-80% of patients, what joints are effected by Rheumatoid arthritis?
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- wrists
- elbows
- ankles
- knees
- cervical spine - At what age is the onset of Rheumatoid arthritis most typical?
- 20-60 years of age, with a peak between 40-50.
- What gender is 3x more likely to get Rheumatoid arthritis?
- Women
- When someone has Rheumatoid arthritis, what is happening on a cellular level?
- There is an inflammatory autoimmune reaction of the synovial tissue
- What antibody does the synovial fluid and blood of up to 70% of Rheumatoid arthritis patients contain?
- The antibody Rheumatoid Factor
- What is "pannus" tissue?
- Proliferating synovial tissue, where granulation tissue covers the normal surface of synovial tissue.
- What pathologic conditions occur in joints with Rheumatoid arthritis?
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- soft tissue swelling
- loss of joint space
- bone erosion
- osteoporosis - What clinical features are present in a patient with Rheumatoid arthritis?
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- Fatigue, malaise, general muscle weakness, low grade fever.
- insidious onset of pain
- Morning stiffness
- enlarged joints
- tender joints
- painful on motion of joints
- warm and red joints
- In chronic cases, joints are indurated and stiff - In a blood panel, what would the doctor find?
- The Anti-cyclic Citrullinated Peptide Antibody (ACCPA), which is 100% specific for Rheumatoid arthritis.
- On an x-ray, what pathologic changes would the doctor see?
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- soft tissue swelling
- marginal erosion
- uniform loss of joint space
- juxta-articular osteoporosis - In the hand, what joints are affected by Rheumatoid arthritis?
- The MCP joints, which cause ulnar deviation.
- In the wrist, what joints are affected by Rheumatoid arthritis?
- The carpals
- What other joints in the body are affected by Rheumatoid arthritis?
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- knees
- feet
- cervical spine in 50-80% of chronic patients
- Odontoid erosion, with damage to the transverse ligament, causing atlanto-axial instability. - If a doctor had a blood lab test peformed what would be found?
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- In 80% of patients, there would be a positive Rheumatoid Factor
- elevated erythrocyte sedimentation rate (ESR) in 90% of patients
- Anemia in 80% of patients
- +C Reactive Protein - What is the treatment for Rheumatoid arthritis?
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- Acute Stage: rest and anti-inflammatories
- In the non-inflammation state: manipulation and exercise
- Improved diet