Rheumatoid Arthritis
Rheumatoid Arthritis: history taking and evaluating a case.
Professor Shaheen Moin.
FRCP. FCPS.
HOD Medicine.
Overview
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Epidemiology
History
Physical Examination
Laboratory Tests
Radiographical signs
Pharmological Treatment
Surgical Treatment of Foot
Epidemiology of Rheumatoid
Arthritis.
• RA affects between 0.5 and 1% of adults in the developed world with between
•
•
•
•
5 and 50 per 100,000 people newly developing the condition each year.
In 2010 it resulted in about 49,000 deaths globally.
The age at which the disease most commonly starts is in women between 40 and 50 years of age, and for men somewhat later.
RA is a chronic disease, and although rarely, a spontaneous remission may occur. The natural course is almost invariably one of persistent symptoms, waxing and waning in intensity, and a progressive deterioration of joint structures leading to deformations and disability
What is Rheumatoid Arthritis?
What needs to be dealt with?
• An autoimmune disease of unknown etiology characterized by involvement of multiple joints, affects the small joints more severely, usually symmetrical, acute attacks and remissions leaving behind progressive joint damage which ultimately results in deformity and permanent disability. Also involves skin and lungs. Causes secondary muscle wasting and bone loss.
• Management. Induce remission, prevent relapses, prevent joint damage, reduce disability, improve joint function surgically, ensure that drugs used do not cause damage, provide social and psychological support.
Goal: maintain QOL
• What is “Quality of Life”? Is your patient receiving good QOL?
• Ability to
• Work
• Be a parent
• Socialize with others
• Exercise and be mobile
Rheumatoid arthritis: effect on the joints.
•
RA affects the synovium.
•
•
•
•
Damages the capsule.
Destroys the cartilage.
Causes secondary bone loss and muscle wasting.
Results in permanently damaged joints with residual disability.
The Synovium in RA
Normal Synovium
Professor Shaheen Moin.
FRCP. FCPS.
HOD Medicine.
Overview
•
•
•
•
•
•
•
Epidemiology
History
Physical Examination
Laboratory Tests
Radiographical signs
Pharmological Treatment
Surgical Treatment of Foot
Epidemiology of Rheumatoid
Arthritis.
• RA affects between 0.5 and 1% of adults in the developed world with between
•
•
•
•
5 and 50 per 100,000 people newly developing the condition each year.
In 2010 it resulted in about 49,000 deaths globally.
The age at which the disease most commonly starts is in women between 40 and 50 years of age, and for men somewhat later.
RA is a chronic disease, and although rarely, a spontaneous remission may occur. The natural course is almost invariably one of persistent symptoms, waxing and waning in intensity, and a progressive deterioration of joint structures leading to deformations and disability
What is Rheumatoid Arthritis?
What needs to be dealt with?
• An autoimmune disease of unknown etiology characterized by involvement of multiple joints, affects the small joints more severely, usually symmetrical, acute attacks and remissions leaving behind progressive joint damage which ultimately results in deformity and permanent disability. Also involves skin and lungs. Causes secondary muscle wasting and bone loss.
• Management. Induce remission, prevent relapses, prevent joint damage, reduce disability, improve joint function surgically, ensure that drugs used do not cause damage, provide social and psychological support.
Goal: maintain QOL
• What is “Quality of Life”? Is your patient receiving good QOL?
• Ability to
• Work
• Be a parent
• Socialize with others
• Exercise and be mobile
Rheumatoid arthritis: effect on the joints.
•
RA affects the synovium.
•
•
•
•
Damages the capsule.
Destroys the cartilage.
Causes secondary bone loss and muscle wasting.
Results in permanently damaged joints with residual disability.
The Synovium in RA
Normal Synovium