1. RHEUMATOID ARTHRITIS RA Inson lou

2. Epidemiology Symptoms signs Labs Diagnosis Treatment

3. Epidemiology Unknown

4. Epidemiology Immune System - an autoimmune disease Gender – Women:men 2-3:1 Genetics Infection

5. Symptoms signs Joint - pain, warmth, stiffness, redness, deformities. it can start in any joint, but also start in wrist, finger, knee, elbow, toe, ankle, back, or neck. often on both sides of the body

6. Symptoms - other Fatigue General discomfort, uneasiness, or malaise Loss of appetite Low-grade fever Round, painless nodules under the skin Skin redness or inflammation Paleness Swollen glands Eye burning, itching, and discharge Numbness or tingling

7. Labs RF ESR X-ray ANA Synovial fluid ( ) analysis / biopsy

8. Osteopenia Cartilage deformity Bone erosion

9. Diagnosis – 1987 revised criteria for the classification of rheumatoid arthritis (>= 4 item) Morning stiffness of the joint >1h,>6w Arthritis of 3 of more joint >6w Arthritis of wrist, metacarpophalangeal joint,( ) or proximal interphalangeal joint. ( ) >6w Symmetric arthritis >6w Rheumatoid nodules Rf (+) Radiographic changes

10. Treatment- general menage Education Rest / Exercise Diet

11. Treatment- Drugs NSAID Corticosteroid

12. Disease – modifying antirheumatic drugs DMARDs Methotrexate Antimalarial drugs Penicillamine,Sulfasalazine.Cyclosporine,Azathioprine, Gold

13. Methotrexate How to use CBC Kidney function test Liver function test Folic acid

14. Surgery Ensure pt. to maintain function.

15. Conclusion

17. Overview Rheumatoid arthritis is a chronic disease, mainly characterized by inflammation of the joints. It can lead to long-term joint damage, resulting in chronic pain, loss of function and disability.