4. Joint Disorder : Rheumatoid Arthritis

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7 Terms

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Rheumatoid Arthritis

Autoimmune systemic Arthritis affecting small joints

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Pathophysiology

Autoantibodies (RF, Anti-CCP) attack the synovium → Pannus formation → joint erosion and deformity

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Signs and Symptoms

  1. Morning stiffness (.30 to 60 mins)

  2. Symmetrical Joint involvement

  3. swelling, warmth, fatigue

  4. Rheumatoid nodules

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Risk Factors

  • Female (30 -50 years old)

  • Family history

  • Smoking

  • HLA - DR4 Gene ( human leukocyte antigen )

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Diagnostics

  1. Rheumatoid Factor , Anti-CCP - Positive in RA

  2. ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) - Markers of inflammation

  3. X-ray - Shows erosions, narrowed joint space

  4. ANA (antinuclear antibody) - May be positive

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Nursing Management

  • Rest During Flares

  • Warm compress for stiffness

  • Joint protection (splints)

  • Range of Motion in remission

  • Energy conservation techniques

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Pharmacologic Treatment

  1. Methotrexate (DMARD) - First-line to slow disease progression.

  2. NSAIDs - For pain and inflammation relief.

  3. Corticosteroids - For flares

  4. Biologics - Target immune pathways (TNF - a inhibition)