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Rheumatoid Arthritis (Clinical Presentation (Extra-articular…
Rheumatoid Arthritis
Clinical Presentation
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Fatigue, sleep disturbed and pain & stiffness are significantly worse in the morning
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Slowly progressive, SYMMETRICAL swollen, painful and stiff
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Aetiology & Risk Factors
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Immune system
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Local production of rheumatoid factor by B cells and formation of immune complexes with complement activation also maintain the chronic inflammation
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Gender
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Before menopause women are affected 3x more than men with an equal sex incidence post-menopause - suggesting aetiological role for sex hormones
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Pathophysiology
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Synovial disease & synovitis occurs when chemoattractants produced in the joint recruit circulating inflammatory cells
The panes (tumour-like mass grown over the surface of cartilage) DESTROYS the articular cartilage and subchondral one resulting in bony erosions
Diagnosis
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Bloods
ESR and/or CRP raised in proportion to the activity of the inflammatory process - useful for monitoring treatment
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