RHEUMATOID ARTHRITIS RA

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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.