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Rheumatoid Arthritis -brief overview

🔺Rheumatoid Arthritis (RA) is a chronic systemic inflammatory condition affecting small and large joints in the body.

🔺Usually seen in both sides- small joints such as hands and feet etc


🔸1% of UK population can get RA

🔸Age- 30-50 years of age - peak onset , can peak at 70 as well

🔸Women 2-4 times > affected than men

🔸Can be associated with heart diease, infections, lymphomas etc

🔸Immediate family member with history of RA



🔺Carpal tunnel syndrome

🔺Tendon ruptures

🔺Joint replacement surgery

🔺Neck related condition- ( cervical myelopathy)


🔺Weight loss

🔺Dry eyes


🔺Enlarged spleen


🔺Painful and tender joints worse at rest and inactive time

🔺Morning stiffness > 1 hour usually for weeks

🔺Boggy swelling in the small joints

🔺Nodules are present in advanced cases on hands as shown


🔸Physical examination- squeeze tests for hands and feet

🔸Symptoms presentation as above

🔸Blood tests- not always positive, Rheumatoid factor ,Anti CCP antibodies , full blood count, liver and renal profile as well as CRP and ESR ( inflammatory markers)

🔸X-ray, Ultrasound and MRI- to check inflammation in the joints at various stages

🔸Referral should be made immediately when suspected of RA


🔸Anti-inflammatories - Naproxen, celecoxib etc if suitable prescribed with stomach lining - protection omeprazole or lanzoprazole

🔸Treat to target strategy - to reduce the disease activity or achieve remission

🔸Rheumatology drugs- DMARDS, Biologics , Immnuoglobilins, boneprotection medicine discuss with specialist

🔸Monitor systemic symptoms- if any issues , contact GP for referral to see specialist

🔸Rheumatology follow ups are suggested to monitor the diease activity as discussed with specialist.

🔸Hydrotherapy, exercises to improve joint stiffness, splinting to improve hand function, see #physiotherapist for specialist advice

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