Download - Rheumatoid Arthritis Ppt
RHEUMATOID ARTHRITIS
What is RA?A Chronic,
systemic inflammatory disease, characterised by symmetrical joint involvement which is typically erosive/destructive. hallmark feature: persistent symmetric polyarthritis (synovitis)
RHEUMATOID ARTHRITIS
Recap on the anatomy and physiology
Function of JOINTS:
• To allow articulation between two or more bones and• secondarily to permit movement by contraction of opposing muscles.
•Unknown
• Genetic
• Autoimmune
Etiology
Pathophysiology
Antigen –Environmental agent, infectious agent
Activates CD4 helper T cells and probably
B lymphocytes
T cells stimulatessynovial macrophage
and fibroblast
Activates B lymphocytes
Genetic Susceptibility HLA-DR4 HLA-DQ HLA- DP
Cytokines
Pathophysiology
Pannus formationJoint destruction Cartilage fibrosis
Ankylosis
Joint injury
RANKL
Activates osteoclast
Formation of rheumatoid
factor
Formation of autoimmune complexes and probable deposition
in the joint
Cytokines
Fibroblast Chondrocytes Synovial cells
Enzymes release (collagenase, streptomelysin, elactase, PGE2 and matrix metalloproteinases, others)
T cells stimulatessynovial macrophage
and fibroblast
Activates B lymphocytes
Proliferation
INTERLEUKIN 1
IL-1 is a potent stimulator of synoviocytes, chondrocytes and osteoblasts (Figure 1).
IL-1 is a proinflammatory cytokine that amplifies and perpetuates the disease process in RA
1. arthritis
Clinical Manifestations
Associated with
•low fever
•Fatigue
•Morning stiffness
•Joint soft, warm to touch
Clinical Manifestations
2. extra-articular features
3. Associated syndromes (possible complications)
Clinical Manifestations
(a) Sjögren’s syndrome-salivary glandinflammation and keratoconjunctivitis(b) Felty’s syndrome-profound neutropenia,thrombocytopenia and splenomegaly(C) Pulmonary involvement-(pleuritis, interstitialpneumonitis, alveolitis and intrapulmonaryrheumatoid nodules)(d) Cardiac involvement-pericarditis
ns
Diagnnostic criteria 1. Morning stiffness lasting more than 1 hour2. Arthritis of 3 or more joint areas. 3. Arthritis of the hand joints 4. Symetric arthritis 5. Rheumatoid nodules over extensor surface or bony prominences. 6. Serum rheumatoid factor. 7. Radiologic changes.
• oligoarticular JIA
•Polyarticular JIA
•Systemic JIA
Types of JIA
1. Acute Pain r/t inflammation & swelling
2. Fatigue r/t increased metabolic rate
3. Impaired physical mobility r/t decreased range of motion
4. Disturbed body image r/t physical & psychological changes
Nursing Diagnosis:
THANK
YOU
FOR
LISTENING!