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