Rheumatoid Arthritis - Pathophysiology, Clinical Manifestations, and Management

Vocabulary flashcards covering the pathophysiology, clinical manifestations, and management concepts of rheumatoid arthritis.

Rheumatoid arthritis (RA)

Autoimmune inflammatory disease characterized by symmetric polyarthritis and systemic involvement; immune-mediated attack on the synovium leading to inflammation and joint destruction.

Pannus

Inflammatory granulation tissue that forms within the RA joint; composed of immune and fibrovascular tissue that invades cartilage and bone, causing erosion.

Rheumatoid factor (RF)

Autoantibody (often IgM) against the Fc portion of IgG; forms immune complexes that drive joint inflammation in RA.

Anti-CCP / ACPA

Autoantibodies against citrullinated proteins; highly specific for RA and useful for diagnosis.

Synovitis

Inflammation of the synovial membrane in the joint, leading to increased fluid, redness, heat, swelling, and pain.

Synovial hyperplasia

Proliferation of synovial lining cells resulting in thickened synovium and pannus formation.

Angiogenesis in RA

Formation of new blood vessels in inflamed synovium to support pannus growth.

Osteoclasts

Bone-resorbing cells; their increased activity in RA contributes to bone erosions.

Osteoblasts

Bone-forming cells; in RA, remodeling can be imbalanced, contributing to deformity and net bone loss.

Ankylosis

Fusion of a joint due to chronic inflammation; results in immobility.

Bilateral symmetric involvement

RA typically affects joints on both sides of the body in a symmetric pattern.

Systemic involvement

RA can affect other organs and tissues (heart, lungs, kidneys, skin); associated with fatigue, sleep disturbance, and depression.

HLA-DRB1

Genetic locus associated with RA susceptibility; part of the HLA class II region.

Remission and exacerbations

RA often has periods of symptom control (remission) punctuated by flare-ups (exacerbations).

Diagnosis criteria features

Diagnosis is supported by features such as prolonged morning stiffness, involvement of multiple joints, symmetric disease, positive RF or anti-CCP, radiographic changes, and elevated inflammatory markers; four of seven features suggest RA.

Management strategies

Lifestyle modification (exercise, smoking cessation, diet), psychosocial support, and pharmacologic strategies to be discussed in further lectures.