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Nirmal Jose Mathew
Group 25
RHEUMATOID ARTHRITIS
Inflammatory
• Rheumatoid arthritis
• Seronegative arthropathy
• Crystal arthropathy
Non Inflammatory
• Osteoarthritis
01 02
Types of Arthritis
Definition
Rheumatoid arthritis is an autoimmune disease in which the
normal immune response is directed against an individual's
own tissue, including the joints, tendons, and bones, resulting
in inflammation and destruction of these tissues.
Etiology and Pathogenesis
 Genetic Factors
• HLA Factors - HLA DR B1 04, HLA DR B1 01
• Non HLA factors - PADI 4 gene, PTPN 22, CTLA 4
 Environmental Factor
• Smoking
• Silica
• Porphyromonas gingivalis
 FemaleGender
 Age >45
Risk Factors
Clinical Picture
Pseudo Deformity
True Deformities
Extra-Articular Characteristics
Blood test: anemia (in almost 50 % of patients), thrombocytosis,
neutropenia, increased ESR and CRP.
Immunological tests: rhematoid factor (RF) and anti-citrullinated protein
(ACCP) antibodies are the main diagnostic biomarkers of RA.
X-ray of hands and distal feet segments: periarticular osteoporosis, joint
space narrowing, single or multiple erosions, joint luxations or subluxations, bone
ankylosis
Laboratory and
Instrumental Diagnosis
Classification criteria for Rheumatoid
arthritis
Treatment
Approved DMARDs :
 Methotrexate - DOC (7.5-20 mg)
 Leflunomide
 Sulfasalazine
 Hydroxychloroquine
Biological Agents
 Infliximab
 Adalimumab
 Tocilizumab
Small molecule
 JAK 3inhibitor
 Barcitinib
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RHEUMATOID ARTHRITIS