90. ra- rheumatoid arthritis
TRANSCRIPT
RA: Rheumatoid ArthritisPathophysiology Course
Inflamed synoviumPannus (hard tissue around joints)
Patho Test Tips
Loss of cartilageAnkylosis (stiffening and immobility)
Iron deficiency anemia
Pannus
Fibrovascular
Granulation
Pathophysiology
RA is an autoimmune disorder where the body attacks the joints causing major inflammation & deformity. Mainly seen in the hand joints, but can also involve other organs (skin, eyes, & lungs) with collateral damage as the body attacks itself.
Autoimmune DisorderMore common in Women
Patho Test Tips
DiagnosticsSynovial fluid aspirationArthroscopy Blood tests: � RF - Rheumatoid factor � ESR - erythrocyte sedimentation rate � CRP - C-reactive protein
Signs & Symptoms
Early SignsFatigue, anorexia (weight loss)& morning joint stiffness
Fingers: swan-neck and a boutonniere deformity
Pain relief with activityMORE pain at rest
Contractures of joints = HIGH priority
Symmetrical pain and swelling in the small joints of the hands
Joint pain EXAM TIP
Boutonniere deformity
Swan-neck deformity
HIGH PRIORITY
Education
Pain control - Assess pain levelsDo NOT elevate the knees with pillows at nightExercise (low impact)
Heat & Cold to affected joints
Swimming
Warm shower or bath before bed
EXAM TIP
Pharmacology
NSAIDsSteroids “-sone”
PrednisoneMethotrexate
STEROIDS-SONE
MethotrexateNSAIDS