Symptoms And Treatment Of Rheumatoid Arthritis

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Rheumatoid Arthritis

Brandon Holley
PAS5430 Winter 2017 - Class 6

Clinical Presentation
Disease Overview. Rheumatoid Arthritis (RA) is considered the most common autoimmune inflammatory arthritis disease diagnosed in adult patients and affects quality of life and leads to increased mortality rates. It is defined as a chronic, inflammatory, systemic autoimmune disorder characterized by symmetric, erosive synovitis that often leads to joint destruction, deformity, and disability. If left untreated, progression of RA could lead to irreversible joint damage, systemic effects including damage to the heart, lungs, & GI system. Early diagnosis and treatment can prevent long term complications and increase odds of remission.
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First degree relatives are at a 2-3 fold higher risk for developing the disease.
Presentation. Patient diagnosed with RA may have medical history of periodontitis, smoking, genetic predisposition, nulliparous, and family history of RA. Genetics may account for approximately 60% of risk associated with RA. Smoking has been the only confirmed environmental trigger for RA. Genes that affect the immune system may make some people more prone to getting RA. Physical symptoms upon exam may be subtle such as achy joints or morning stiffness. Other symptoms may include swelling, tenderness, limitation of joint movement, joint deformity, and warmth of involved joints. Less common presenting factors include fever, weight loss, and lyphadenopathy. Muscle atrophy could present near affected joints along with disproportionate weakness. Cutaneous findings are common and may include nodules with ulcers or petechia, purpura, or nodular erythema related to vascultitis. RA usually starts to affect small joints in the fingers, balls of the feet, and the wrists bilaterally. As disease progresses, RA can affect any joint, causing permanent damage, and even lead to systemic damage. Extraarticular manifestations may include anemia, pericarditis, Raynaud’s, interstitial lung disease, scleritis, neuropathy, pleuritis, lynphadenopathy, and splenomegaly. Initial evaluation of the patient with RA should include documentation of symptoms of
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