Condition Info - BotMed Application

ConditionName

Rheumatoid arthritis (RA)

ConditionDescription

Symptoms

Morning stiffness, multiple small, inflamed joints, better with use;
Morning stiffness >30min for 6 weeks;
Symmetrical;
Multiple joints of hand and feet;
Bilateral, PIP, MCP;

Inflammatory condition;

Some well have rheumatic nodules, episcleritis, lung nodules end effusions, vasculitis, sclerites;

Boutonniere and swan neck hand deformities;

NO DJD involvement!

Ulnar deviations;

PhysicalFindings

ClinicalTests

For diagnosis:
ACPA Abs (anti-citrullinated peptide/protein antibody ) and/or;
RF – IgG ABs;

3+ joints;
Anti-cyclic citrullinated peptide (anti-CCP);

anti-CCP: positive only in 25-50%, not R/O RA;
Predict aggressive joint erosion.

↑ESR;
↑CRP;
Anemia of chronic dz;

RF is not specific;

xRay: joint space narrowing, physical deformity of joints;
MRI more accurate for early stage;

RiskFactors

Middle age and elderly female
Type 3 hypersensitivity
Associated with HAL-DR4 serotype

IsRedFlag

IsNPLEX

Consequence

Pericarditis;
Interstitial lung dz;
Pleural effusion;
Pulmonary nodules;

ProgressionFromCondition

TreatmentOptions

PharmOptions

Make dz early!
Refer to rheumatologist in real life;

If NSAIDs (best for pain) or steroids (add to NSAIDs to control pain or as a bridge for DDARD) do not work -> DMARD (slow onset of action);

Steroids do not prevent progression of RA!

DMARD: Methotrexate slow progression of RA;
May be combined with Adalimumab;

Hydroxychloroquine;

WebLink

https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/joint-disorders/rheumatoid-arthritis-ra