Flashcards in Clinical Aspects of Rheumatoid Arthritis Deck (13)
What is the definition of rheumatoid arthritis?
Rheumatoid Arthritis is a chronic auto immune systemic illness characterised by a symmetrical peripheral arthritis and other systemic features
What may rheumatoid arthritis be associated with?
What is the ARA criteria for rheumatoid arthritis?
-Arthritis of 3 or more joint areas
-Arthritis of hand joints
-Serum rheumatoid factor
What is the prevalence and incidence of RA?
-Approx 1% of population
-Approx 200 ne cases per year in Grampian
Who gets RA?
-Peak age of onset in 4th/5th decase but may occur at any age from 16 years
What is the aetiology of RA?
-Link with siblings in particular monozygotic twins
-Genetic contribution estimated to be 50-60%
-Closest association with specific amino acid sequences at positions 70-74 of DRB1 (sheared epitope)
-Chronic infection e.g periodontal disease
What is the pathogenesis of RA?
Inflamed synovial membrane
Pannus (abnormal layer of fibrovascular/ granulation tissue)
-Major cell types: T lymphocytes and macrophages
-Minor cell types: fibroblasts, plasma cells, endothelium dendritic cells
-Major cell type: neutrophils
How is RA investigated?
-Rheumatoid factor (IgG, IgM)
-Anti Cyclic Citrullinated Antibodies (anti CCP, ACPA)
What are the symptoms of RA?
What are the clinical signs of RA?
-Limitation of movement
What are the systemic features of RA?
How is RA assessed?
Disease activity score
- DAS<2.4 represents clinical remission
-DAS>5.1 represents eligibility for biologic therapy