RHEUMATOID ARTHRITIS

RHEUMATOID ARTHRITIS

1. Autoimmune Disease

   • Potential Source of Systemic Manifestations
     • Nervous System
       • Peripheral Neuropathy
     • Epidermis
       • Thinning
       • Ulcerations
     • Pleura
       • Effusions
     • Lymph Nodes
       • Reactive
       • Lymphadenopathies
     • Pericardium
       • Effusions
     • Eye
       • Scleritis
       • Keratoconjunctivitis
     • Kidney
       • Amyloidosis
     • Lungs
       • Fibrosis
       • Nodules
       • Effusions
     • Gut
       • Amyloidosis
     • Spleen
       • Splenomegaly
     • Bone Marrow
       • Thrombocytosis
       • Anemia
     • Muscle
       • Wasting
   • B cells
     • release antibodies
   • T cells
     • produce cytokines

2. SIGNS & SYMPTOMS

   • Joints Affected Bilaterally
     • Ball of Foot
     • Jaw
       • Temporomandibular Joint
     • Knees
       • Femoropatellar Joint
     • Elbows
       • Glenohumeral Joint
     • Shoulders
       • Acromioclavicular AC joint
     • Fingertips
     • Knuckles
     • Wrists
   • Joint Inflammation
     • Tenderness
     • Warmth
     • Swelling
     • Erythema
       • Blood Capillaries Dialate
   • Subcutaneous Nodules
     • Inflammation of Blood Vessels
   • Pain
   • Debilitating
   • Weight Loss
   • Cardiovascular Issues
   • Musculoskeletal
     • Damage to Muscle Tissue
     • Sprains
     • Fractures
     • Breaks in Bones
   • Irreversible Joint Deformities
     • Ulnar Deviation of Phalanges
     • Boutonniere Deformities
       • Hyperextension of Distal Interphalangeal Joints
       • Flexion of Proximal Interphalangeal Joints
     • Swan Neck Deformities
       • Hyperextension of Proximal Interphalangeal Joints
       • Flexion of Distal Interphalangeal Joints
   • Fluid Buildup

3. Inflammation of Synovial Tissue

4. DIAGNOSIS

   • Prolonged Morning Stiffness
   • Arthritis in 3 or more Joints; Simultaneous Swelling
   • Arthritis Bilaterally
   • Rheumatoid Nodules
   • Radiographic Changes
   • Positive Serum Rheumatoid Factor
   • Blood Tests
     • Reveals Rheumatoid Factor
       • Antibodies in Blood That Connect to Synovium of Joint
     • C-active Protein
       • Indicates General Inflammation
     • Anti-CCP Antibody
       • Can Identify RA Before Symptoms Progress
   • Imaging Tests
     • Types
       • MRI
       • Ultrasound
       • X-rays
         • Tracks Progression of Joint Damage Over Time

5. TREATMENT

   • Medication
     • NSAIDS
       • Naproxen Ketoprofen Ibuprofen Aspirin
       • Side Effects
         • High BP; Skin Bruising; Fluid Retention; Reduced Kidney Function; Rash
     • DMARDS
       • Leflunomide Methotrexate Sulfasalazine Minocycline Tofacitinib Hydroxychloroquine
       • Side Effects
         • Mouth Sores; Muscle Aches; Nausea; Rash; Vomiting; Headache
         • Severe
           • Kidney & Liver Damage; Lung Disease; Increased Chance of Infection & Birth Defects
     • BIOLOGICAL DMARDS
       • Etanercept Certolizumab Golimumab Adalimumab
       • Side Effects
         • Headache; Pain at Injection Site; Nausea; Flu-like Symptoms
     • CORTICOSTEROIDS
       • Oral Injection Low-dose
       • Side Effects
         • Osteoporosis; Cataracts; Glaucoma; Diabetes; Hypertension; Insomnia
   • Lifestyle Changes
     • Exercise
       • R.O.M
         • Tai Chi
       • Stretching
     • Diet
       • Fish Oil
         • Omega-3 Fatty Acids
   • Surgery
     • Synovectomy
       • Removal of Joint Lining
     • Arthroplasty
       • Joint Replacement
     • Arthroscopy
       • Debridement
     • Arthrodesis
       • Joint Fusion
         • Only in Spine & Smaller Joints

6. RISK FACTORS

   • Gender
     • Women
   • Age
     • 30-50
   • Smoking
   • Family History
   • Gene
     • Cytogenetic Location: 6p21.3 Molecular Location on Chromosome 6: base pairs 32,546,545 to 32,557,612
       • HLA-DRB1 Human Leukocyte Antigen
         • HLA-DRB1 Beta Chain
           • HLA class II histocompatibility antigen, DRB1-1 beta chain