Autoimmune Arthritis
Definition
Clinical Features
Symptoms
Signs
Investigations
Bloods:
Imaging:
DDX
Treatment
Conservative
Meds
Complications
RA
Source
Dr Alasdair MacDonald 2014
- Autoimmune mediated inflammation of joints
Clinical Features
Symptoms
- Morning stiffness, improving with activity
Signs
- Ulnar deviation, Z deformity, Boutonniere deformity, Swan neck deformity
- Subcutaneous nodules
- CVS, eye, respiratory, (interstitial lung disease) vasculitis
Investigations
Bloods:
- FBC (inflammatory/ Felty's), UEC (baseline), ESR (indicates severity), CRP, RF, anti-CCP (useful predictor - early marker)
- LFT (baseline), CMP (baseline), uric acid, ANF (SLE)
Imaging:
- X ray hands (urgent if bone erosion) + chest (ILD)
- Nuclear bone scan
- X ray signs
- soft tissue swelling
- joint space narrowing
- periarticular osteopenia
- well defined erosion
DDX
- Psoriatic arthritis (only difference is desquamating rash with plaques + pitted nails)
Treatment
Conservative
- Avoidance (lifestyle, suncreen)
- Psychological support
- OT (ADL: open jars)
- Education
- Sx rx
- Physical therapy
Meds
- Paracetamol
- DMARDs/ Methotrexate
- Corticosteroids
- Sulfasalazine
- Plaquenil (hydroxychloroquine - sefx: retinal)
Complications
RA
- Eyes (Episcleritis/ scleritis/ Sicca)
- Lungs (pulmonary fibrosis)
- Vasculitis
- Felty's (anaemia)
Source
Dr Alasdair MacDonald 2014