unmanned

Labs for rheumatoid arthritis

CBC

CRP

Anti-cyclic citrullinated peptide anti-CCP specific.

rheumatoid factor – IGM Auto antibody against IgG

ANA

TFT

Swan neck

Seen in rheumatoid arthritis

Hyperextension of PIP

hyper flexion of DIP

XRAY for RA shows

Joint space narrowing

Marginal erosions of cartilage and bone

Subchondral cysts

Management of rheumatoid arthritis

Acute; NSAID, prednisone at lower dose

Maintain: taper steroid use, give DMARD( methotrexate,hydroxychloroquinone)

Boutainare deformity

PIP flexion

DIP hyperextension

Other symptoms seen in RA

Morning stiffness more than 30 mins

Relieve with activity

Atlantoaxial subluxation

Piano key sign; dorsal subluxation of ulna

Extrasystemic symptoms of RA

Malaise, low grade fever, fatigue

Rheumatoid nodiles in high pressure point

Caplan syndrome (lungs)

Scleritis

anemia of chronic disease; NNA

Carpel tunnel syndrome

Raynaud

Bony prominance in distal part of DIP

Heberdon nodes; osteoarthrtitis

Bouchard nodes: pain and nodular prominance on the dorsal sides of the PIP

osteoarthritis

Nature of RA; inflmama

tory

Nature of osteoarthritis (degenrative)