Rheumatoid Arthritis

Rheumatoid arthritis -Chronic progressive , systemic inflammatory disease characterized by the progressive destruction of synovial joints

Most common autoimmune inflammatory arthritis in adults Prevalence of about 0.5 to 1 % in Western population Developing countries have a lower prevalence Women are affected 2-4 times more common than men Incidence increases with age with a peak onset in 4th and 5th decades Aetiology is poorly understood- possibly multifactorial Amongst environmental factors smoking has now emerged as a clear external risk Bone erosion Cartilage destruction- hallmark of RA

Rheumatoid arthritis causes significant disability- patients experience difficulty performing ADLs ( activities of daily life ) Has a significant impact on health related quality of life Approximately 1/3rd of people stop work because of RA within 2 yrs of its onset ( NICE 2009 ) Systemic effects of RA contribute to a 5-15 yr reduction in life expectancy ↑ mortality rate ( 2.4 and 2.5 /100 person-yrs for men and women )

Presentation-Joint pain swelling stiffness , affects commonly○ wrists ○ proximal interphalangeal jt○ metacarpophalangeal jt○ metatarsophalangeal jt AM stiffness or stiffness after inactivity - lasting over 30 mins Systemic symptoms as○ weight loss○ fatigue○ malaise Swelling of three or more joints Tenderness largely...