Quick Revision 4 - Rheumatoid Arthritis part 1

Rheumatoid Arthritis = Symetrical polyarthritis of unknown aetiology that leads to joint erosions. It is a clinical diagnosis supported by rheumatoid factors as prognosticating factor.

ARA criteria for RA (4 or more of the following criteria)

"RF RISES"

R - Rheumatoid factors - RF and anti-CCP positive likely RA
F - Finger / hand joints involved for 6 weeks or more

R - Rheumatoid nodules
I - Involvement of 3 or more joint areas
S - Symmetrical arthritis 6 weeks or more
E - Erosions on X-ray
S - Stiffness (morning stiffness for 1 hour lasting for 6 weeks or more)

Other related problems:

1) Splenomegaly: due to Primary disease, Felty's syndrome, Sjorgren's syndrome, amyloidosis

2) Anemia: of chronic disease, Felty's, bleeding gastric ulcer (due to analgesics), bone marrow suppression (cytotoxic drugs)

3) Respiratory complications : Pleuritis/effusion, Interstitial pulmonary fibrosis, iatrogenic - asthma (NSAID), interstitial fibrosis (MTX)

4) Neurological complications : Carpal tunnel syndrome, atlanto-axial subluxation leading to cervical myelopathy, and mononeuritis multiplex