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Tuesday, January 10, 2012

PowerPoint Presentation On Rheumatoid Arthritis

Rheumatoid Arthritis PPT


Presentation Transcript:
1. Rheumatoid Arthritis

2. Goals
General Approach to Arthritis
Rheumatoid Arthritis
Diagnostic Criteria
Therapeutic Approach
Disease Severity and Course

3. Rheumatoid Arthritis: Definition
Progressive, systemic, inflammatory disorder
Unknown etiology
Characterized by
Symmetric synovitis
Joint erosions
Multisystem extra-articular manifestations

4. Epidemiology of Rheumatoid Arthritis
Approximately 1% of the total adult population is affected by RA
40% to 60% with advanced (functional class IV) RA will:
Survive 5 years or less following diagnosis
Die 10-15 years earlier than expected

5. Approach to Arthritis

6. Joint Pain
most common symptom
Pain (arthralgia) vs. Inflammation (arthritis)
heat, redness, pain, swelling, loss of function
inflammatory arthritis (RA, SLE) vs. pain syndrome (fibromyalgia)

7. Number of Joints Affected
Reactive Arthritis
OA: joint effusions
Autoimmune disease
Psoriasis, IBD, AS, Behçet's
Monoarticular causes
Viral infection
Acute Serum Sickness
Untreated Crystal-induced

8. Inflammatory vs. Non-Inflammatory
Inflammatory: i.e. RA
Generalized AM stiffness
> 30 min
Resolves with movement
Classic signs of inflammation

Non-Inflammatory: i.e. Osteoarthritis
Localized AM stiffness
< 30 min 9. Arthrocentesis Confirm diagnoses Differentiate between inflammatory & noninflammatory Therapeutic/Adjunct to Antibiotics Labs: cell count w/diff crystal analysis Gram stain & Culture WBC >2000/µL indicates inflammatory arthritis

Evaluate ligamentous & cartilaginous integrity
Infectioun: aspirate thick or loculated fluid

9. RA
Systemic inflammatory autoimmune disorder
~1% of population
Onset: 52 years
40-70 years of age
<60 - 3-5:1 female predominance

10. Genetics
Increased incidence among Pima & Chippewa Native American tribes (5%)
Genetic & Environmental

HLA-DRB1*0401 & HLA-DRB1*0404
Increased risk
Increased joint damage
Increased joint surgery

11. Pathophysiology

12. Immunology
Produce cytokines
Cytokines (TNF-α) cause systemic features
Release chemokines  recruit PMNs into synovial fluid/membrane

TNF-α & IL-1:
Proliferation of T cells
Activation of B cells
Initiates proinflammatory/joint-damaging processes

TH-1 cells:
Mediate disease processes
Activate B cells

B cells:
Release cytokines
Plasma cells that produce Ab

Bone erosion
Juxta-articular & Systemic osteoporosis

13. Pathophysiology
Swelling of Synovial lining

Rapid division/growth of cells = Pannus
Synovial thickening/hyperplasia
Inflammatory vascularized tissue
Generation of Metalloproteinases

Cytokine release
Infiltration of leukocytes
Change in cell-surface adhesion molecules & cytokines
Destruction of bone & cartilage

14. Bottom Line Proliferation Destruction of joints Disability

15. For more info please refer PPT. Thanks

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