Rheumatoid Arthritis F:M 2.5:1 Symmetric arthritis Inflammatory Exam may resemble SLE However, RA causes bony erosions, irreversible

Rheumatoid Arthritis Historical rx: steroids, gold 1990s: Methotrexate 1998: Biologics Diminishing frequency of extraarticular (EA) disease features such as vasculitic ulcers

RA: Common Features Sjogren syndrome: Dry eyes, mouth Parotitis May be associated with purpura, renal disease, neuropathy

RA: Common Features Rheumatoid nodules Extensor surfaces Painless, do not erode May be confused with gouty tophi

RA: Scleritis Nodules are not always “benign” Nodular scleritis is painful, can be catastrophic Aggressive po steroids

RA: Scleritis Painful red eye is an emergency in RA Scleritis may cause globe rupture

ANCA Vasculitis (Wegener’s)

Wegener granulomatosis Saddle nose deformity Lung nodules Hematuria, renal failure