1. Rheumatoid Arthritis

2. What is it?
Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disease
Cause is often unknown
Usually affects synovial tissue of diarthrodial joints
Systemic inflammation causes structural damage

3. Who is the most at risk?
Women are 2-3 times more likely to be affected then men
Most commonly between the ages of years old
Women who take oral contraceptives are less likely to acquire RA

4. Risk factors Although the exact mechanism is unknown
Commonly believed risk factors include
Genetics
Environmental factors
Hormones

5. Signs and Symptoms Symptoms begin gradually
Weeks to months
Morning stiffness over 45 minutes
Duration of stiffness increases as the disease progresses
May present as diffuse, bilateral joint pain and tenderness to palpation

6. Signs and Symptoms The acronym “SERIOUS” can help identify RA
Swelling in one or more joints
Early morning stiffness
Recurring pain or tenderness in any joint
Inability to move a joint normally
Obvious redness and warmth in a joint
Unexplained weight loss, fever, or weakness combined with joint pain
Symptoms last more than 2 weeks
* American Rheumatism Association Criteria for Classification of RA

7. Functional deficits Joint pain limits ability to: Walk C limb stairs
Open doors
ADLs

8. Radiographic imaging Joint erosion visible in 70-90% of individuals.
Radiographic changes are often found on the posteroanterior aspect of the hands and wrist
Bony decalcification in involved joints

9. Joints affected Cervical spine Shoulder Elbows Hands Hips Knees Ankles
MTP and MCP joints especially
Hips
Knees
Ankles

10. Extra-articular features
Rhematoid nodules
Arteritis
Neuropathy
Scleritis
Pericarditis
Lymphadenopathy
Splenomegaly

11. What to do next?
If the patient presents with these signs and symptoms and has not been diagnosed by a physician, a referral is warranted
Serious health related problems can develop
Aggressive medications and treatment will improve outcome