RHEUMATOID ARTHRITIS:

RHEUMATOID ARTHRITIS:

It is a chronic symmetrical relapsing poly-arthritis affecting mainly the peripheral small joints associated with some constitutional symptom. It is a Progressive, systemic, inflammatory disorder of unknown etiology Characterized by

- Symmetric synovitis

- Joint erosions

- Multisystem extra-articular manifestations.

CAUSES:

The cause of RA is not known, however it is thought that some people inherit genes that affect the way the immune system works making them more susceptible to the disease than others. Environmental factors such as an infection may also trigger RA and generate an immune response.

CLINICAL PRESENTATION

n Gradual onset

n Stiffness & Swelling

n Intermittent or Migratory involvement

n Extraarticular manifestations

n Myalgia, fatigue, low-grade fever, wt loss, depression

Stiffness & Swelling

n Pain with pressure to joint

n Pain with movement of joint

n Swelling due to hypertrophy

n Effusion

n Heat

n Redness

Physical Exam

n Decreased grip strength

n Boxing glove edema

n Carpal tunnel

n Ulnar deviation

n Boutonniere/Swan neck deformities

n Extensors tendon rupture

Extraarticular Involvement

n Anemia

n Rheumatoid nodules

n Pleuropericarditis

n Neuropathy

n Episcleritis, Scleritis

n Splenomegaly

n Sjogren’s

n Vasculitis

Diagnosis of Rheumatoid Arthritis

1)X-Ray joint.
2) Synovial biopsy.
3) CBC.
4) Synovial fluid analysis.
5) Rheumatoid factor.

Diagnostic Criteria:

n Symmetric peripheral polyarthritis

n AM Stiffness >1 hour

n Rheumatoid nodules

n Laboratory features

n Radiographic bone erosions

COMPLICATIONS OF RHEUMATOID ARTHRITIS

- Subluxation of atlanto-axial joint.
- Carpal tunnel syndrome.
- Fibrosing alveolitis.
- Sjogren’s syndrome.
- Septicarthritis.