RHEUMATOID ARTHRITIS

Autoimmune Disease
1. Potential Source of Systemic Manifestations
  1. Nervous System
    1. Peripheral Neuropathy
  2. Epidermis
    1. Thinning
    2. Ulcerations
  3. Pleura
    1. Effusions
  4. Lymph Nodes
    1. Reactive
    2. Lymphadenopathies
  5. Pericardium
    1. Effusions
  6. Eye
    1. Scleritis
    2. Keratoconjunctivitis
  7. Kidney
    1. Amyloidosis
  8. Lungs
    1. Fibrosis
    2. Nodules
    3. Effusions
  9. Gut
    1. Amyloidosis
  10. Spleen
    1. Splenomegaly
  11. Bone Marrow
    1. Thrombocytosis
    2. Anemia
  12. Muscle
    1. Wasting
2. B cells
  1. release antibodies
3. T cells
  1. produce cytokines
SIGNS & SYMPTOMS
1. Joints Affected Bilaterally
  1. Ball of Foot
  2. Jaw
    1. Temporomandibular Joint
  3. Knees
    1. Femoropatellar Joint
  4. Elbows
    1. Glenohumeral Joint
  5. Shoulders
    1. Acromioclavicular AC joint
  6. Fingertips
  7. Knuckles
  8. Wrists
2. Joint Inflammation
  1. Tenderness
  2. Warmth
  3. Swelling
  4. Erythema
    1. Blood Capillaries Dialate
3. Subcutaneous Nodules
  1. Inflammation of Blood Vessels
4. Pain
5. Debilitating
6. Weight Loss
7. Cardiovascular Issues
8. Musculoskeletal
  1. Damage to Muscle Tissue
  2. Sprains
  3. Fractures
  4. Breaks in Bones
9. Irreversible Joint Deformities
  1. Ulnar Deviation of Phalanges
  2. Boutonniere Deformities
    1. Hyperextension of Distal Interphalangeal Joints
    2. Flexion of Proximal Interphalangeal Joints
  3. Swan Neck Deformities
    1. Hyperextension of Proximal Interphalangeal Joints
    2. Flexion of Distal Interphalangeal Joints
10. Fluid Buildup
Inflammation of Synovial Tissue
DIAGNOSIS
1. Prolonged Morning Stiffness
2. Arthritis in 3 or more Joints; Simultaneous Swelling
3. Arthritis Bilaterally
4. Rheumatoid Nodules
5. Radiographic Changes
6. Positive Serum Rheumatoid Factor
7. Blood Tests
  1. Reveals Rheumatoid Factor
    1. Antibodies in Blood That Connect to Synovium of Joint
  2. C-active Protein
    1. Indicates General Inflammation
  3. Anti-CCP Antibody
    1. Can Identify RA Before Symptoms Progress
8. Imaging Tests
  1. Types
    1. MRI
    2. Ultrasound
    3. X-rays
      1. Tracks Progression of Joint Damage Over Time
TREATMENT
1. Medication
  1. NSAIDS
    1. Naproxen Ketoprofen Ibuprofen Aspirin
    2. Side Effects
      1. High BP; Skin Bruising; Fluid Retention; Reduced Kidney Function; Rash
  2. DMARDS
    1. Leflunomide Methotrexate Sulfasalazine Minocycline Tofacitinib Hydroxychloroquine
    2. Side Effects
      1. Mouth Sores; Muscle Aches; Nausea; Rash; Vomiting; Headache
      2. Severe
        Kidney & Liver Damage; Lung Disease; Increased Chance of Infection & Birth Defects
  3. BIOLOGICAL DMARDS
    1. Etanercept Certolizumab Golimumab Adalimumab
    2. Side Effects
      1. Headache; Pain at Injection Site; Nausea; Flu-like Symptoms
  4. CORTICOSTEROIDS
    1. Oral Injection Low-dose
    2. Side Effects
      1. Osteoporosis; Cataracts; Glaucoma; Diabetes; Hypertension; Insomnia
2. Lifestyle Changes
  1. Exercise
    1. R.O.M
      1. Tai Chi
    2. Stretching
  2. Diet
    1. Fish Oil
      1. Omega-3 Fatty Acids
3. Surgery
  1. Synovectomy
    1. Removal of Joint Lining
  2. Arthroplasty
    1. Joint Replacement
  3. Arthroscopy
    1. Debridement
  4. Arthrodesis
    1. Joint Fusion
      1. Only in Spine & Smaller Joints
RISK FACTORS
1. Gender
  1. Women
2. Age
  1. 30-50
3. Smoking
4. Family History
5. Gene
  1. Cytogenetic Location: 6p21.3 Molecular Location on Chromosome 6: base pairs 32,546,545 to 32,557,612
    1. HLA-DRB1 Human Leukocyte Antigen
      1. HLA-DRB1 Beta Chain
        HLA class II histocompatibility antigen, DRB1-1 beta chain

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RHEUMATOID ARTHRITIS

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	Created by Marina Acquaroli over 11 years ago