It is a systemic chronic inflammatory disease affecting multiple tissue but principally attacking the joints, with a peripheral symmetrical non-suppurative arthritis.
Onset: 30-40 y/o
F:M ratio = 3:1
Need to meet 4/7 criteria.
Pneumonic : RF RISES
R : Rheumatoid Factor ( it is not a diagnostic for RA because it can present in other dz
F : Finger/ hand joints involved
R : Rheumatoid nodules ( firm, non tender, oval/rounded mass )
I : Involvement of 3 or more joint area
S : Stiffness in morning => 1 hr
E : Erosions on Xray (xray findings: narrow jt space, erosion of ulnar and radial aspect of PIP jt)
S : Symmetrical arthritis
* Rheumatoid Factor = is an IgM (or can be IgG) autoantibodies directed against Fc portion of IgG
* destruction of tendon, ligament and joint capsules produces characteristics deformities including radial deiation of wrist, ulnar deviatian of finger and flexion-hyperextension of abnormalities of fingers (swan-neck deformity, boutonniere deformity)
Typical clinical manifestation in RA :
- presenting in women of middle age
- begin insidiously, slow development of sign and symptom
- joint inflammation ( pain,swelling, morning stiffness)
- pain gradually relieve on movement
- involving small joint, mostly proximal interphalangeal jt (PIP) and metacarpophlangeal (MCP), distal interphalangeal (DIP) mostly spared
- polyarticular
- symmetrical
- nonspecific sign and symptom ( fatigue, malaise and depression )
* reference: xpress revision in short case (pg 126), pathophysiologyof disease (pg 687), basic patho, internet
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