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the pathophysiology of joint disease 1: rheumatoid arthritis £7.49   Add to cart

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the pathophysiology of joint disease 1: rheumatoid arthritis

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includes: patient case example, aetiology and pathogenesis, signs and symptoms, role of cytokines, inflammation as the cause of joint damage, consequences, markers of inflammation, treatment

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  • December 21, 2023
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  • 2021/2022
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Sunday, 16th January 2022
Week 1
Medicine
The Pathophysiology of Joint Disease 1
Rheumatoid arthritis
Patient
 Maria
o 46
o Female
o 3 months of pain and swelling in small joints of hands and feet
o Stiffness in early morning for about 60 minutes
What do we notice?
 Relatively young
 Short duration over months
 Non-specific pain
 Swelling implies inflammation
 Stiffness in the early morning takes a long time to stop
 Inflammatory
Take a history and examine joints
 Joint swelling over thumb, index and middle finger
o Cannot see the valleys between MCP joints
 Swelling of PIP joints
Test results
 CRP 15 ESR 48 moderate inflammatory response
 Rf – 40 – positive
 CCP 120 – significantly raised
 ANA – neg
Diagnosis
 History of inflammation of small joints, morning stiffness
 Can see swelling on examination and it is symmetrical
 Positive antibodies for rheumatoid arthritis
 Most likely diagnosis rheumatoid arthritis
Rheumatoid arthritis
 1% prevalence
 Untreated can cause increased morbidity
o Moderate to severe disability over 10-year period
 Significant impact on job prospects
o High job loss in 1st year
 Costs are significant
o Population burden
Symptoms and signs
 Insidious onset
o Over months
 Joint swelling
 Prolonged stiffness
o Early morning
o Lasts over 30 minutes
 MCPs, MTPs and wrists

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