Post on 26-Mar-2015
RHEUMATOID ARTHRITIS RA
Inson lou
Epidemiology Symptoms signs Labs Diagnosis Treatment
Epidemiology
Unknown
Epidemiology
Immune System - an autoimmune disease
Gender – Women:men 2-3:1
Genetics Infection
Symptoms signs
Joint - pain, warmth, stiffness, redness, deformities.
it can start in any joint, but also start in wrist, finger, knee, elbow, toe, ankle, back, or neck.
often on both sides of the body
Symptoms - other Fatigue General discomfort, uneasiness, or malaise Loss of appetite Low-grade fever Round, painless nodules under the skin Skin redness or inflammation Paleness Swollen glands Eye burning, itching, and discharge Numbness or tingling
Labs
RF ESR X-ray ANA Synovial fluid (滑液 ) analysis / biopsy
Osteopenia 骨質減少
Cartilage deformity 軟骨畸形
Bone erosion 骨質侵蚀
Diagnosis – 1987 revised criteria for the classification of rheumatoid arthritis (>= 4 item)Morning stiffness of the joint >1h ,>6wArthritis of 3 of more joint >6wArthritis of wrist, metacarpophalangeal joint,( 掌指關節 ) or proximal interphalangeal joint. ( 近側指指關節 ) >6wSymmetric arthritis >6wRheumatoid nodulesRf (+)Radiographic changes
Treatment- general menage
Education Rest / Exercise Diet
Treatment- Drugs
NSAID Corticosteroid
Disease – modifying antirheumatic drugs DMARDs
Methotrexate Antimalarial drugs 抗疟药 Penicillamine 青霉胺 ,Sulfasalazine 柳氮磺胺吡啶 .Cyclosporine ,Azathioprine 硝基咪唑硫嘌呤 , Gold
Methotrexate
How to use CBC Kidney function test Liver function test Folic acid
Surgery
Ensure pt. to maintain function.
Conclusion
Overview
Rheumatoid arthritis is a chronic disease, mainly characterized by inflammation of the joints. It can lead to long-term joint damage, resulting in chronic pain, loss of function and disability.