my hands are aching

my hands are aching

1. Demography

   • Farida
   • 45 years old
   • clinical presentation
     • pain in the hand
       • hand joints
         • wrist joint
         • CMC
         • MCP
         • IP
       • hand bones
         • Radius
         • Ulna
         • carpal bones
           • Scaphoid
           • lunate
           • triquitrum
           • pisiform
           • trapezium
           • trapezoid
           • capitate
           • hamate
           • carpal tunnel
             • flexor retinacula
             • Flexor digitorum P and S tendons
             • Median nerve
             • Flexor polices longus tendon
             • Flexor carpi radialus
         • metacarpal
         • phalanx

2. Rheumatoid arthritis

   • Autoimmune disease
     • immunology
       • pannus formation
         • lymphocytes
         • macrophages
         • plasma cells
         • neutrophils
         • mast cells
         • cytokines
       • failure of tolerance
         • central
           • Thymus
         • peripheral
           • T reg cells
     • causes
       • genetics
       • environmental factors
   • affecting the whole body
     • joints
       • synovial membrane
         • synovial fluid
     • kidney
     • eyes
     • Bones
       • osteoporosis
   • Symptoms
     • pain
     • swelling
   • diagnosis
     • criteria
       • RF+
         • IgM
         • Binds to
           • IgG(Anti-DNA)-DNA complex
             • damages the
       • symmetrical arthritis
       • 3 or more joints
       • morning pain >1 hr
       • arthritis of hand joints
       • rheumatoid nodules
       • radio changes erosions
         • Xray
           • findings
             • Ulnar deviation of MCP
             • Swan neck deformity
             • Butonierre deformity
       • periarticular osteopenia
       • FOR >6 weeks
   • Treatment
     • NSAIDs
     • DMARDs
     • BIO therapies
     • corticosteroids

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