Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation of the joints. The document summarizes the definition, epidemiology, risk factors, pathophysiology, signs and symptoms, complications, diagnosis, and treatment of RA. It describes the clinical presentation of a patient with possible RA and the steps to take which include performing a physical exam, ordering diagnostic tests, making a provisional diagnosis, and referring the patient to a rheumatologist for further evaluation and management. Non-pharmacologic and pharmacologic treatment options for RA are outlined.
Arthritis - An Overview - Dr Rajendra Sharmamrinal joshi
This document provides information on arthritis and its management. It discusses the clinical examination and chronology of complaints in arthritis patients. It then focuses on rheumatoid arthritis, covering its definition, clinical features, laboratory tests, radiographic findings, disease activity scales, and treatment recommendations. It also discusses osteoarthritis, rehabilitation interventions, joint protection principles, and assistive devices. The overall document aims to outline the assessment and management of the most common arthritic conditions.
Rheumatoid arthritis is an autoimmune disease that causes joint pain and damage throughout the body in a symmetrical pattern. The cause is unknown but factors like being a female, family history, infections, smoking, and obesity may increase risk. Symptoms include joint pain, swelling, and stiffness. Diagnosis involves clinical, lab, and imaging evaluations. Treatments include medications like NSAIDs, steroids, DMARDs, biologics, and JAK inhibitors to reduce inflammation and slow progression.
This document discusses rheumatoid arthritis (RA), an autoimmune disease where the immune system attacks the synovium lining the joints, causing pain, swelling, and inflammation. It covers signs and symptoms of RA like joint stiffness and pain. Risk factors include genetics and gender, with most cases occurring between ages 35-50. Treatment involves NSAIDs, DMARDs, corticosteroids, biologics, and JAK inhibitors to reduce inflammation and slow disease progression. The pathology involves cytokines and immune cells that promote inflammation, and diagnosis is based on symptoms, physical exam, blood tests, and x-rays.
Osteoarthritis is a chronic degenerative disorder of synovial joints in which there is progressive softening and erosion/disintegration of the articular cartilage. In the presentation, I will deal in detail about the condition in every dimension with the most recent evidence.
Rheumatoid arthritis is a chronic inflammatory disease that affects the joints, causing pain, stiffness, and swelling. It can also impact other body systems. While the exact cause is unknown, genetics and environmental factors are believed to play a role. Common symptoms include joint deformities, fatigue, and anemia. Diagnosis involves evaluating symptoms, physical exam findings, blood tests, and x-rays. Treatment focuses on reducing inflammation and joint damage through medications like DMARDs, NSAIDs, and corticosteroids. The goals are to relieve symptoms, improve function, and prevent disability. Care requires a multidisciplinary approach including medication management, exercise, and lifestyle changes.
Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that causes inflammation of small and medium arteries. It predominantly affects the arteries of the kidneys, heart, liver, and gastrointestinal tract, causing ischemia and tissue damage. The pathology is characterized by segmental necrotizing inflammation of the arterial walls. PAN is diagnosed based on biopsy of an affected organ showing arteritis or angiography demonstrating aneurysms of small and medium arteries. Treatment involves high-dose glucocorticoids and cyclophosphamide to induce remission, though relapse can occur in 10-20% of cases.
Psoriatic arthritis is a chronic inflammatory disease that affects both the joints and skin. It is classified as a spondyloarthropathy and can affect both men and women equally. The disease occurs in 4-6% to 30% of patients with psoriasis. Genetic and environmental factors contribute to its development, and tumor necrosis factor alpha plays a key role in driving joint inflammation. Treatment involves NSAIDs, disease-modifying antirheumatic drugs like methotrexate, and biologics that target tumor necrosis factor alpha.
Arthritis - An Overview - Dr Rajendra Sharmamrinal joshi
This document provides information on arthritis and its management. It discusses the clinical examination and chronology of complaints in arthritis patients. It then focuses on rheumatoid arthritis, covering its definition, clinical features, laboratory tests, radiographic findings, disease activity scales, and treatment recommendations. It also discusses osteoarthritis, rehabilitation interventions, joint protection principles, and assistive devices. The overall document aims to outline the assessment and management of the most common arthritic conditions.
Rheumatoid arthritis is an autoimmune disease that causes joint pain and damage throughout the body in a symmetrical pattern. The cause is unknown but factors like being a female, family history, infections, smoking, and obesity may increase risk. Symptoms include joint pain, swelling, and stiffness. Diagnosis involves clinical, lab, and imaging evaluations. Treatments include medications like NSAIDs, steroids, DMARDs, biologics, and JAK inhibitors to reduce inflammation and slow progression.
This document discusses rheumatoid arthritis (RA), an autoimmune disease where the immune system attacks the synovium lining the joints, causing pain, swelling, and inflammation. It covers signs and symptoms of RA like joint stiffness and pain. Risk factors include genetics and gender, with most cases occurring between ages 35-50. Treatment involves NSAIDs, DMARDs, corticosteroids, biologics, and JAK inhibitors to reduce inflammation and slow disease progression. The pathology involves cytokines and immune cells that promote inflammation, and diagnosis is based on symptoms, physical exam, blood tests, and x-rays.
Osteoarthritis is a chronic degenerative disorder of synovial joints in which there is progressive softening and erosion/disintegration of the articular cartilage. In the presentation, I will deal in detail about the condition in every dimension with the most recent evidence.
Rheumatoid arthritis is a chronic inflammatory disease that affects the joints, causing pain, stiffness, and swelling. It can also impact other body systems. While the exact cause is unknown, genetics and environmental factors are believed to play a role. Common symptoms include joint deformities, fatigue, and anemia. Diagnosis involves evaluating symptoms, physical exam findings, blood tests, and x-rays. Treatment focuses on reducing inflammation and joint damage through medications like DMARDs, NSAIDs, and corticosteroids. The goals are to relieve symptoms, improve function, and prevent disability. Care requires a multidisciplinary approach including medication management, exercise, and lifestyle changes.
Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that causes inflammation of small and medium arteries. It predominantly affects the arteries of the kidneys, heart, liver, and gastrointestinal tract, causing ischemia and tissue damage. The pathology is characterized by segmental necrotizing inflammation of the arterial walls. PAN is diagnosed based on biopsy of an affected organ showing arteritis or angiography demonstrating aneurysms of small and medium arteries. Treatment involves high-dose glucocorticoids and cyclophosphamide to induce remission, though relapse can occur in 10-20% of cases.
Psoriatic arthritis is a chronic inflammatory disease that affects both the joints and skin. It is classified as a spondyloarthropathy and can affect both men and women equally. The disease occurs in 4-6% to 30% of patients with psoriasis. Genetic and environmental factors contribute to its development, and tumor necrosis factor alpha plays a key role in driving joint inflammation. Treatment involves NSAIDs, disease-modifying antirheumatic drugs like methotrexate, and biologics that target tumor necrosis factor alpha.
Osteoarthritis: It covers all the aspects of Osteoarthritis such as definition, etiology, pathophysiology, management such as pharmacotherapy, and non-pharmacological treatment.
The document discusses rheumatoid arthritis (RA), a chronic inflammatory disease that affects the joints and can damage heart tissue over time. It provides definitions of RA, discusses common symptoms like joint pain and stiffness, outlines diagnostic criteria and investigations used to diagnose the condition, such as checking for rheumatoid factor in the blood. The document also summarizes the pathological stages of RA and long term effects like joint deformity and disability.
Rheumatoid arthritis is a chronic autoimmune disease characterized by inflammation of the joints that can lead to long-term joint damage and disability. It is caused by the immune system attacking the synovial membrane and joint lining, causing swelling and stiffness. Common symptoms include pain, swelling, and stiffness in the small joints of the hands and feet. While the exact cause is unknown, genetic and environmental factors are believed to play a role. Treatment focuses on reducing inflammation and preventing further joint damage through medications, physical therapy, exercise, and sometimes surgery.
Juvenile rheumatoid arthritis (JRA), also known as juvenile idiopathic arthritis (JIA), is a type of arthritis that causes joint inflammation and stiffness in children aged 16 or younger for more than six weeks. There are three main types of JRA: pauciarticular JRA which affects 4 or fewer joints, polyarticular JRA which affects 5 or more joints, and systemic JRA which causes symptoms unrelated to joints like fever and rash. The causes of JRA are unknown but it is an autoimmune disease where the immune system mistakenly attacks the body's own tissues in the joints. Symptoms include swollen or painful joints, fever, rash, and eye inflammation. Diagnosis
This document provides information on rheumatoid arthritis (RA), including:
- RA is an autoimmune disease that results in chronic systemic inflammation, principally attacking synovial joints. It affects 1-3% of adults and is more common in women.
- Clinical manifestations include symmetrical joint pain, stiffness, and swelling typically in the hands, wrists and feet. This can lead to deformities like ulnar deviation.
- Extra-articular effects can include heart, lung, eye, nerve, and skin involvement.
- Diagnosis is based on criteria like joint symptoms lasting over 6 weeks and serological markers. Treatment aims to reduce inflammation and prevent joint damage.
The document discusses osteoarthritis of the knee, including:
1. Risk factors for osteoarthritis like age, gender, genetics, obesity, and joint injuries.
2. Clinical features like pain, stiffness, swelling, crepitus, and deformity.
3. Diagnostic tools like x-rays, MRI, CT, and arthroscopy that can assess cartilage damage and bone changes.
4. Treatment approaches including medications, physical therapy, weight loss, bracing, injections, and surgeries like arthroscopy, osteotomies, knee replacements, and arthrodesis.
Ankylosing spondylitis is a form of chronic arthritis that primarily affects the spine. It causes inflammation and stiffness of the spinal joints and surrounding tissues, which can eventually lead to a complete fusion of the spinal bones. The condition is strongly associated with the HLA-B27 genetic marker and tends to develop early, between ages 18-30. While the exact cause is unknown, genetics and immune system factors like tumor necrosis factor are thought to play a role. There is no cure, but treatments can help reduce symptoms, slow the progression, and manage pain.
Rheumatoid arthritis is an autoimmune disease that causes inflammation, swelling, and pain in the joints. It affects approximately 1% of the world's population and 0.92% of the adult population in India. There are two main types - seropositive RA, where the body produces immune reactions to normal tissue, and seronegative RA, where tests for rheumatoid factor and anti-CCP antibodies are negative. Risk factors include age 40-60, family history, smoking, obesity, and female sex. Diagnosis involves evaluating symptoms, x-rays of affected joints, and blood tests for rheumatoid factor and anti-CCP antibodies. Treatment includes non-pharmacological therapies as well as drugs like
Osteoarthritis and rheumatoid arthritis are chronic joint disorders. Osteoarthritis involves the progressive breakdown of articular cartilage in a joint. It is associated with aging and risk factors like obesity, joint injury, and genetics. Rheumatoid arthritis is an autoimmune disease where the immune system attacks the joints, causing pain, stiffness, and swelling. It can eventually damage cartilage and bone within joints and may affect other organs. Both diseases are diagnosed based on symptoms, physical exam, x-rays, and blood tests. Treatment focuses on reducing pain and inflammation, maintaining joint mobility, and may include medications, weight loss, or joint replacement surgery.
Rheumatoid arthritis is a chronic autoimmune disease that causes inflammation of the joints. It affects around 1% of the global population and is three times more common in women than men. While the exact cause is unknown, genetic and environmental factors are believed to play a role. RA results in painful swelling of the joints, stiffness, and over time can cause permanent joint damage and deformity. Diagnosis involves physical exam, blood tests to check for inflammatory markers and autoantibodies, and x-rays. Treatment aims to reduce inflammation and prevent further joint damage through medications, exercise, and assistive devices. While there is no cure, early and aggressive treatment can help control symptoms and minimize disability.
Physiotherapy management for rheumatoid arthritissenphysio
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. It most commonly affects women and can lead to joint damage, deformity, and disability over time. Physiotherapy plays an important role in managing rheumatoid arthritis by providing pain relief, preventing deformities, improving flexibility and strength, and maintaining functional ability. Treatment involves heat/cold therapy, exercises, joint protection techniques, and alternative therapies to help reduce inflammation and preserve joint function. The goals of physiotherapy are to protect joints, relieve pain, and prevent disability through regular exercise and mobility work.
Physiotherapy Management of the Rheumatoid HandSayantika Dhar
This document discusses hand deformities that can occur in rheumatoid arthritis. It defines rheumatoid arthritis and describes the immune response and genetic factors involved. Common hand deformities seen in late-stage RA are described such as swan neck, boutonniere, and MP joint ulnar deviation. Evaluation of hand deformities focuses on features like synovitis, nodules, crepitus, range of motion, strength and pain level. Management principles emphasize protection of joints through rest, activity balancing, pain-free exercise and avoiding positions of deformity.
Fibromyalgia is a disorder characterized by widespread musculoskeletal pain, stiffness, and tender points. It predominantly affects women and prevalence increases with age. The diagnosis is based on a history of widespread pain for at least 3 months and pain in 11 of 18 tender points. While the cause is unknown, it involves central sensitization and neuroendocrine abnormalities. Treatment includes medications, exercise, stress management, CBT, and alternative therapies. The ACR is proposing new diagnostic criteria incorporating symptoms like fatigue and cognitive problems in place of tender points.
Rheumatoid arthritis is an autoimmune disease characterized by chronic inflammation of the joints which can lead to joint damage and physical disability. It is a progressive disease affecting the synovial lining of peripheral joints, causing symmetrical inflammation and potentially deforming polyarthritis. Symptoms include tender swollen joints, morning stiffness lasting hours, fatigue, and rheumatoid nodules under the skin. Treatment focuses on relieving pain, reducing inflammation, protecting joints, maintaining function, and controlling systemic effects through use of drugs like NSAIDs, DMARDs, biologics, glucocorticoids, and surgery.
Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes symmetrical joint inflammation. It affects around 1% of the population, predominantly women aged 30-50. Genetic and environmental factors contribute to its development. RA is characterized by synovitis and infiltration of inflammatory cells into the synovium, resulting in cartilage and bone destruction. Common clinical features include pain, stiffness, and swelling of small joints. Left untreated, RA can cause joint deformity and damage to other body systems. Investigations reveal elevated inflammatory markers and autoantibodies. Management involves a multidisciplinary approach including medications to relieve symptoms and slow disease progression.
Osteoarthritis is a degenerative joint disease characterized by cartilage breakdown. It is the most common form of arthritis, often affecting the knees in 70% of people over age 60. Osteoarthritis can cause functional impairment and disability in older adults and is a leading cause of joint replacement surgery. Risk factors include age, obesity, genetics, and joint trauma. Treatment focuses on reducing pain and preserving function through lifestyle changes, physical therapy, braces, and medications like acetaminophen, NSAIDs, and opioids. Surgery is considered for severe, treatment-resistant cases.
This document provides information on rheumatoid arthritis (RA), including its definition, epidemiology, pathophysiology, clinical features, diagnosis, treatment, and importance for physiotherapy. RA is a chronic inflammatory autoimmune disease that causes destruction and deformity in joints. It most commonly affects the hands, wrists, elbows, knees, and feet. Diagnosis involves assessing symptoms, blood tests like rheumatoid factor and CRP, and x-rays. Treatment focuses on reducing inflammation and preventing further joint damage using medications like NSAIDs, DMARDs, corticosteroids, methotrexate, and biologic DMARDs. Physiotherapy plays an important role through patient education, lifestyle modifications, and exercises to preserve
Wilson's disease is a genetic disorder caused by a mutation on the ATP7B gene that results in too much copper being absorbed and retained in the body's organs like the liver and brain. It is typically diagnosed through tests measuring copper levels in the blood and liver tissue. Lifelong treatment focuses on removing excess copper through medication or transplant and preventing further copper absorption through diet.
Rheumatoid arthritis is a chronic inflammatory disease that causes pain, stiffness, and swelling in the joints. It occurs when the immune system mistakenly attacks the joints, causing the synovial membrane to become inflamed. Over time, this can cause cartilage and bone damage and limit function. Treatment focuses on reducing inflammation, managing symptoms, and preventing further joint damage through medications, surgery, and lifestyle changes. While there is no cure, proper treatment can help improve quality of life by reducing pain and disability.
Osteoarthritis: It covers all the aspects of Osteoarthritis such as definition, etiology, pathophysiology, management such as pharmacotherapy, and non-pharmacological treatment.
The document discusses rheumatoid arthritis (RA), a chronic inflammatory disease that affects the joints and can damage heart tissue over time. It provides definitions of RA, discusses common symptoms like joint pain and stiffness, outlines diagnostic criteria and investigations used to diagnose the condition, such as checking for rheumatoid factor in the blood. The document also summarizes the pathological stages of RA and long term effects like joint deformity and disability.
Rheumatoid arthritis is a chronic autoimmune disease characterized by inflammation of the joints that can lead to long-term joint damage and disability. It is caused by the immune system attacking the synovial membrane and joint lining, causing swelling and stiffness. Common symptoms include pain, swelling, and stiffness in the small joints of the hands and feet. While the exact cause is unknown, genetic and environmental factors are believed to play a role. Treatment focuses on reducing inflammation and preventing further joint damage through medications, physical therapy, exercise, and sometimes surgery.
Juvenile rheumatoid arthritis (JRA), also known as juvenile idiopathic arthritis (JIA), is a type of arthritis that causes joint inflammation and stiffness in children aged 16 or younger for more than six weeks. There are three main types of JRA: pauciarticular JRA which affects 4 or fewer joints, polyarticular JRA which affects 5 or more joints, and systemic JRA which causes symptoms unrelated to joints like fever and rash. The causes of JRA are unknown but it is an autoimmune disease where the immune system mistakenly attacks the body's own tissues in the joints. Symptoms include swollen or painful joints, fever, rash, and eye inflammation. Diagnosis
This document provides information on rheumatoid arthritis (RA), including:
- RA is an autoimmune disease that results in chronic systemic inflammation, principally attacking synovial joints. It affects 1-3% of adults and is more common in women.
- Clinical manifestations include symmetrical joint pain, stiffness, and swelling typically in the hands, wrists and feet. This can lead to deformities like ulnar deviation.
- Extra-articular effects can include heart, lung, eye, nerve, and skin involvement.
- Diagnosis is based on criteria like joint symptoms lasting over 6 weeks and serological markers. Treatment aims to reduce inflammation and prevent joint damage.
The document discusses osteoarthritis of the knee, including:
1. Risk factors for osteoarthritis like age, gender, genetics, obesity, and joint injuries.
2. Clinical features like pain, stiffness, swelling, crepitus, and deformity.
3. Diagnostic tools like x-rays, MRI, CT, and arthroscopy that can assess cartilage damage and bone changes.
4. Treatment approaches including medications, physical therapy, weight loss, bracing, injections, and surgeries like arthroscopy, osteotomies, knee replacements, and arthrodesis.
Ankylosing spondylitis is a form of chronic arthritis that primarily affects the spine. It causes inflammation and stiffness of the spinal joints and surrounding tissues, which can eventually lead to a complete fusion of the spinal bones. The condition is strongly associated with the HLA-B27 genetic marker and tends to develop early, between ages 18-30. While the exact cause is unknown, genetics and immune system factors like tumor necrosis factor are thought to play a role. There is no cure, but treatments can help reduce symptoms, slow the progression, and manage pain.
Rheumatoid arthritis is an autoimmune disease that causes inflammation, swelling, and pain in the joints. It affects approximately 1% of the world's population and 0.92% of the adult population in India. There are two main types - seropositive RA, where the body produces immune reactions to normal tissue, and seronegative RA, where tests for rheumatoid factor and anti-CCP antibodies are negative. Risk factors include age 40-60, family history, smoking, obesity, and female sex. Diagnosis involves evaluating symptoms, x-rays of affected joints, and blood tests for rheumatoid factor and anti-CCP antibodies. Treatment includes non-pharmacological therapies as well as drugs like
Osteoarthritis and rheumatoid arthritis are chronic joint disorders. Osteoarthritis involves the progressive breakdown of articular cartilage in a joint. It is associated with aging and risk factors like obesity, joint injury, and genetics. Rheumatoid arthritis is an autoimmune disease where the immune system attacks the joints, causing pain, stiffness, and swelling. It can eventually damage cartilage and bone within joints and may affect other organs. Both diseases are diagnosed based on symptoms, physical exam, x-rays, and blood tests. Treatment focuses on reducing pain and inflammation, maintaining joint mobility, and may include medications, weight loss, or joint replacement surgery.
Rheumatoid arthritis is a chronic autoimmune disease that causes inflammation of the joints. It affects around 1% of the global population and is three times more common in women than men. While the exact cause is unknown, genetic and environmental factors are believed to play a role. RA results in painful swelling of the joints, stiffness, and over time can cause permanent joint damage and deformity. Diagnosis involves physical exam, blood tests to check for inflammatory markers and autoantibodies, and x-rays. Treatment aims to reduce inflammation and prevent further joint damage through medications, exercise, and assistive devices. While there is no cure, early and aggressive treatment can help control symptoms and minimize disability.
Physiotherapy management for rheumatoid arthritissenphysio
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. It most commonly affects women and can lead to joint damage, deformity, and disability over time. Physiotherapy plays an important role in managing rheumatoid arthritis by providing pain relief, preventing deformities, improving flexibility and strength, and maintaining functional ability. Treatment involves heat/cold therapy, exercises, joint protection techniques, and alternative therapies to help reduce inflammation and preserve joint function. The goals of physiotherapy are to protect joints, relieve pain, and prevent disability through regular exercise and mobility work.
Physiotherapy Management of the Rheumatoid HandSayantika Dhar
This document discusses hand deformities that can occur in rheumatoid arthritis. It defines rheumatoid arthritis and describes the immune response and genetic factors involved. Common hand deformities seen in late-stage RA are described such as swan neck, boutonniere, and MP joint ulnar deviation. Evaluation of hand deformities focuses on features like synovitis, nodules, crepitus, range of motion, strength and pain level. Management principles emphasize protection of joints through rest, activity balancing, pain-free exercise and avoiding positions of deformity.
Fibromyalgia is a disorder characterized by widespread musculoskeletal pain, stiffness, and tender points. It predominantly affects women and prevalence increases with age. The diagnosis is based on a history of widespread pain for at least 3 months and pain in 11 of 18 tender points. While the cause is unknown, it involves central sensitization and neuroendocrine abnormalities. Treatment includes medications, exercise, stress management, CBT, and alternative therapies. The ACR is proposing new diagnostic criteria incorporating symptoms like fatigue and cognitive problems in place of tender points.
Rheumatoid arthritis is an autoimmune disease characterized by chronic inflammation of the joints which can lead to joint damage and physical disability. It is a progressive disease affecting the synovial lining of peripheral joints, causing symmetrical inflammation and potentially deforming polyarthritis. Symptoms include tender swollen joints, morning stiffness lasting hours, fatigue, and rheumatoid nodules under the skin. Treatment focuses on relieving pain, reducing inflammation, protecting joints, maintaining function, and controlling systemic effects through use of drugs like NSAIDs, DMARDs, biologics, glucocorticoids, and surgery.
Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes symmetrical joint inflammation. It affects around 1% of the population, predominantly women aged 30-50. Genetic and environmental factors contribute to its development. RA is characterized by synovitis and infiltration of inflammatory cells into the synovium, resulting in cartilage and bone destruction. Common clinical features include pain, stiffness, and swelling of small joints. Left untreated, RA can cause joint deformity and damage to other body systems. Investigations reveal elevated inflammatory markers and autoantibodies. Management involves a multidisciplinary approach including medications to relieve symptoms and slow disease progression.
Osteoarthritis is a degenerative joint disease characterized by cartilage breakdown. It is the most common form of arthritis, often affecting the knees in 70% of people over age 60. Osteoarthritis can cause functional impairment and disability in older adults and is a leading cause of joint replacement surgery. Risk factors include age, obesity, genetics, and joint trauma. Treatment focuses on reducing pain and preserving function through lifestyle changes, physical therapy, braces, and medications like acetaminophen, NSAIDs, and opioids. Surgery is considered for severe, treatment-resistant cases.
This document provides information on rheumatoid arthritis (RA), including its definition, epidemiology, pathophysiology, clinical features, diagnosis, treatment, and importance for physiotherapy. RA is a chronic inflammatory autoimmune disease that causes destruction and deformity in joints. It most commonly affects the hands, wrists, elbows, knees, and feet. Diagnosis involves assessing symptoms, blood tests like rheumatoid factor and CRP, and x-rays. Treatment focuses on reducing inflammation and preventing further joint damage using medications like NSAIDs, DMARDs, corticosteroids, methotrexate, and biologic DMARDs. Physiotherapy plays an important role through patient education, lifestyle modifications, and exercises to preserve
Wilson's disease is a genetic disorder caused by a mutation on the ATP7B gene that results in too much copper being absorbed and retained in the body's organs like the liver and brain. It is typically diagnosed through tests measuring copper levels in the blood and liver tissue. Lifelong treatment focuses on removing excess copper through medication or transplant and preventing further copper absorption through diet.
Rheumatoid arthritis is a chronic inflammatory disease that causes pain, stiffness, and swelling in the joints. It occurs when the immune system mistakenly attacks the joints, causing the synovial membrane to become inflamed. Over time, this can cause cartilage and bone damage and limit function. Treatment focuses on reducing inflammation, managing symptoms, and preventing further joint damage through medications, surgery, and lifestyle changes. While there is no cure, proper treatment can help improve quality of life by reducing pain and disability.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. It can affect multiple organs in the body. Risk factors include sex, age, family history, smoking, and obesity. Genetic factors contribute to pathogenesis. Symptoms include joint pain, stiffness, and swelling. Diagnosis is based on clinical and lab criteria. Treatments include medications like NSAIDs, DMARDs, steroids, and biologics as well as physical therapy and exercise to preserve joint function and prevent deformity. Surgery may be needed in cases of severe joint damage.
Rheumatoid arthritis (RA) facts
Rheumatoid arthritis is an autoimmune disease that can cause chronic inflammation of the joints and other areas of the body.
It can affect people of all ages.
The cause of rheumatoid arthritis is not known.
In rheumatoid arthritis, multiple joints are usually, affected in a symmetrical pattern.
Chronic Musculoskeletal Disorders and Physical Therapy Management Prochnost
This document discusses chronic musculoskeletal disorders (MSDs) that commonly affect the neck, back, shoulders, hips, knees, wrists and feet. It provides details on osteoarthritis, rheumatoid arthritis, gout, fibromyalgia, tennis elbow and other conditions. For each condition, it describes causes, signs and symptoms, assessment findings and physical therapy management approaches such as exercises, modalities and joint protection strategies.
Pediatric rheumatoid arthritis is a form of arthritis that affects approximately 1 in 1,000 children each year. It involves inflammation of one or more joints and can cause pain, swelling, and stiffness. The most common types are juvenile rheumatoid arthritis and arthritis following a viral or bacterial infection. Treatment focuses on controlling inflammation through medications like DMARDs and biologics to prevent joint damage and disability. Nurses monitor for signs of arthritis, ensure proper treatment, educate patients and families, and help patients manage pain and maintain function.
Rheumatic diseases include rheumatoid arthritis and psoriatic arthritis. Rheumatoid arthritis is an autoimmune disease that causes inflammation and destruction of joints, tendons, and bones. It affects around 1% of the adult population and women more than men. While the cause is unknown, genetic and environmental factors are involved. Symptoms include joint stiffness, pain, swelling and decreased range of motion. Treatment involves medications like NSAIDs, DMARDs and corticosteroids to relieve symptoms and slow disease progression. Psoriatic arthritis causes joint pain and swelling in some joints and scaly skin patches, with symptoms varying between individuals.
Rheumatoid arthritis is a chronic inflammatory disease that causes stiffness, swelling, and pain in the joints. It is an autoimmune disorder where the immune system mistakenly attacks the body's own tissues, causing a inflammatory reaction in the synovial membranes surrounding the joints. It most commonly affects the hands, feet and wrists. Risk factors include female gender and genetic factors. Symptoms include symmetric joint pain and stiffness that typically affects the same joints on both sides of the body. Management involves medications to reduce inflammation and prevent joint damage, exercise and physical therapy to maintain joint mobility, and surgery in severe cases.
This document provides information on different types of arthritis. It begins by defining arthritis as joint inflammation and pain that limits movement. The three most common types are then described as osteoarthritis, rheumatoid arthritis, and gout. Osteoarthritis is defined as a "wear and tear" type of arthritis that affects cartilage and bone in the joints. Risk factors, symptoms, and treatments are outlined. Rheumatoid arthritis is an autoimmune disease that causes swelling in multiple joints on both sides of the body. Gout involves uric acid crystal buildup in a joint causing sudden severe pain. Diagnosis and management of each type is briefly discussed.
Rheumatoid arthritis is a chronic inflammatory disease that affects the joints, characterized by progressive destruction of symmetric joints. It is caused by a combination of genetic and environmental factors that lead to an immune system attack on the joints. The disease causes pain, swelling, stiffness, and loss of function in the affected joints. Treatment involves medications to reduce inflammation and prevent further joint damage, including NSAIDs, steroids, DMARDs, and biologic DMARDs. Lifestyle changes and surgery may also be used to treat rheumatoid arthritis and improve quality of life.
This document provides guidance on evaluating and managing patients presenting with monoarthritis or polyarthritis. It discusses common causes of monoarthritis including septic, traumatic, and crystal deposition diseases. It also reviews key questions to ask patients and appropriate diagnostic tests. For polyarthritis, it distinguishes between acute and chronic presentations and lists associated diseases. The document then focuses on osteoarthritis, outlining risk factors, symptoms, diagnostic criteria, and pharmacological and non-pharmacological treatment approaches including exercise, weight loss, analgesics, and surgery.
This document discusses three types of arthritis: osteoarthritis, rheumatoid arthritis, and gout. It defines each type, describes their causes, risk factors, symptoms, diagnostic measures, and treatment options. Osteoarthritis is the most common type and involves the breakdown of cartilage in joints. Rheumatoid arthritis is an autoimmune disease causing inflammation of the lining of joints. Gout is caused by uric acid crystals depositing in joints due to high uric acid levels. Nursing interventions focus on managing symptoms, medication administration, education, and lifestyle changes.
Rheumatoid arthritis (RA) is a disease that leads to inflammation of the joints and surrounding tissues. It is a long-term disease. It can also affect other organs.
RA can occur at any age, but is more common in middle age. Women get RA more often than men.
Infection, genes, and hormone changes may be linked to the disease. Smoking may also be linked to RA.
This document discusses spondyloarthritis (SpA), a group of inflammatory diseases that share features like axial joint inflammation, asymmetric oligoarthritis, and enthesitis. The main types of SpA are ankylosing spondylitis, psoriatic arthritis, undifferentiated spondyloarthritis, and reactive arthritis associated with inflammatory bowel disease. SpA is strongly associated with the HLA-B27 gene. Clinical features include inflammatory back pain, peripheral arthritis, enthesitis, dactylitis, and eye and bowel inflammation. Diagnosis involves assessing clinical features, lab tests like elevated CRP/ESR and HLA-B27 status, and imaging of the sacroiliac joints and spine
This document discusses pain management in rheumatic diseases. It presents a pain classification grid that categorizes different types of pain based on factors like duration, progression, and malignancy. It provides examples of common rheumatic conditions like osteoarthritis and rheumatoid arthritis. It discusses goals of treatment, which include reducing pain and disability as well as limiting joint damage progression. A variety of symptomatic treatment options are outlined, including education, exercise, medications, injections, and surgery.
This document discusses pain management in rheumatic diseases. It begins with a pain classification grid that categorizes different types of pain based on factors like duration and underlying pathology. Next, it reviews non-pharmacologic and pharmacologic treatment options for managing rheumatic pain, including education, exercise, analgesics, anti-inflammatory drugs and injections. It then focuses on osteoarthritis (OA) and rheumatoid arthritis (RA), discussing their prevalence, diagnostic criteria, management goals, and differences between the two conditions. Finally, it reviews the risks and benefits of NSAIDs and COX-2 inhibitors for pain relief in OA and RA patients.
Rheumatoid arthritis is a chronic autoimmune disease that causes inflammation of the joints. It commonly affects the hands, feet, wrists, knees, and neck. The cause is unknown but is likely multifactorial involving genetic and environmental factors. Symptoms include pain, stiffness, and swelling in the joints that is usually worse in the morning. Treatment focuses on reducing inflammation and preventing further joint damage using medications such as NSAIDs, corticosteroids, DMARDs, and biologics. DMARDs like methotrexate are first-line therapies but biologics that target TNF-alpha are also used when other treatments are ineffective. The goal of treatment is to reduce symptoms, prevent disability, and slow disease
This document discusses colorectal cancer (CRC) prevention and early detection in Puerto Rico. It provides statistics on CRC incidence and mortality rates in Puerto Rico from 2000-2016. CRC is the second leading cause of cancer in men and women in Puerto Rico. The document reviews CRC screening guidelines and risk factors. It also presents data on CRC stage at diagnosis and survival rates in Puerto Rico compared to the US. The economic impact of cancer in Puerto Rico is also discussed.
This document provides information on cardiovascular risk factors and interventions for prevention and treatment. It discusses modifiable risk factors like smoking, diabetes, diet, physical activity, and alcohol intake. It reviews evidence for nonpharmacological interventions like weight loss, dietary modifications, exercise, and moderation of alcohol. It also summarizes several clinical trials demonstrating the benefits of statin therapy in primary and secondary prevention of cardiovascular events.
This document discusses elderly depression, suicide risk, and treatment options. It notes that depression is a leading cause of disability worldwide. Late life depression prevalence is estimated at 1-3% of those aged 65 and older. Risk factors for late life depression include chronic illness, cognitive impairment, and lack of social support. Screening tools like the PHQ-9 and GDS can help assess depression severity. Treatment may include psychotherapy, pharmacotherapy, partial hospitalization, or inpatient care depending on symptom severity and suicide risk. Managing elderly depression requires considering medical comorbidities and choosing appropriate treatment.
This document discusses obesity, including its definitions, classifications, prevalence, physiology, and management. It provides guidelines for clinicians on their role in weight loss, including counseling strategies to promote behavior change. New guidelines for obesity management are presented, along with selecting appropriate medications based on a patient's comorbidities. Surgical and non-surgical procedures for obesity are outlined, along with expected weight loss and vitamin deficiencies. The role of nutrition, physical activity, behavior therapy, and medical therapy in obesity treatment is also examined.
This document discusses vaccination standards and immunization schedules for adults and pediatrics in the United States for 2019. It was authored by Dr. Luis J. Lugo Vélez and covers information from the Advisory Committee on Immunization Practices (ACIP) such as their role in developing vaccination recommendations and meeting schedule. It also includes the recommended vaccination schedules for children/adolescents and notes from various schedules. Additionally, it discusses diseases prevented by vaccines and compares morbidity rates pre-and-post widespread vaccination.
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3. Definition
• A chronic, systemic,
inflammatory
autoimmune disease
• Most common form of
inflammatory disease
that affects diarthrodial
joints, causing a painful
swelling
• It can lead to bone
erosion and irreversible
joint deformity and
disability
Epidemiology
• Female:male – 3:1
• Age of onset – 35 to
50 years old
• Prevalence – 1 per
100 patients
• Incidence – 0.5 per
1000 persons per
year in the U.S.
4. AgeFamily
GenderImmune system
Gender
Women are more
likely to develop RA
than men are.
Age
RA can occur at any
age, but it most
commonly begins
between the ages of
40 and 60.
Family History
Cases of RA in the
family may increase
the risk of the
disease
Immune System
RA occurs when the
immune system
mistakenly attacks
body’s tissues
5. • The pathogenesis of RA is not completely understood. An external trigger (eg, cigarette smoking,
infection, or trauma) that triggers an autoimmune reaction, leading to synovial hypertrophy and chronic
joint inflammation along with the potential for extra-articular manifestations, is theorized to occur in
genetically susceptible individuals.
• Synovial cell hyperplasia and endothelial cell activation are early events in the pathologic process that
progresses to uncontrolled inflammation and consequent cartilage and bone destruction. Genetic
factors and immune system abnormalities contribute to disease propagation.
• CD4 T cells, mononuclear phagocytes, fibroblasts, osteoclasts, and neutrophils play major cellular roles
in the pathophysiology of RA, whereas B cells produce autoantibodies (ie, RFs). Abnormal production of
numerous cytokines, chemokines, and other inflammatory mediators (eg, tumor necrosis factor alpha
[TNF-a], interleukin [IL]-1, IL-6, IL-8, transforming growth factor beta [TGF-ß], fibroblast growth factor
[FGF], and platelet-derived growth factor [PDGF]) has been demonstrated in patients with RA.
• Ultimately, inflammation and exuberant proliferation of the synovium (ie, pannus) leads to destruction
of various tissues, including cartilage, bone, tendons, ligaments, and blood vessels. Although the
articular structures are the primary sites involved by RA, other tissues are also affected.
6. Polyarticular
(>4 joints)
Systemic
• Swelling and tenderness of
small peripheral joints
(metacarpophalangeal (MCP)
joints, proximal
interphalangeal (PIP) joints of
the fingers, interphalangeal
joints of the thumbs,
metatarsophalangeal (MTP)
joints and wrists)
• Larger peripheral joints may
become affected - ankles,
knees, elbows and shoulders
• Firm bumps of tissue under
the skin (nodules)
• Fever, weight loss
or fatigue
• Morning stiffness
that may last for
hours ≥1 hour
• Limited range of
motion
7.
8. • Clinical evaluations should be done periodically as a
response to new symptoms.
• Monitor the patient for the conditions below and if any
co-morbidities arise refer to a specialist.
• ACR
• Uveitis/scleritis
• Lung involvement
• Renal
• Vasculitis
• Perciarditis
Episcleritis Vasculitis
Perciarditis
9. Osteoporosis Heart problems
Carpal tunnel syndrome Lung disease
• RA along with some
medications can increase the
risk of osteoporosis
•RA can increase the risk of
hardened and blocked arteries,
as well as inflammation of the
sac that encloses the heart
• If RA affects the wrists, the
inflammation can compress the
nerve that serves most on hand
and fingers
• RA have an increased risk of
inflammation and scarring of
the lung tissues, which can lead
to progressive shortness of
breath
11. • Revised ACR/EULAR 2010 classification criteria for RA
Source: American College of Rheumatology, Celltrion, EULAR
The new 2010
classification system
redefines the current
RA paradigm by
focusing on the
features at earlier
disease stages that
are associated with
persistent and
erosive disease,
rather than defining
the disease by its
late-stage features.
12. • CR, a 40 year old woman noted bilateral hand discomfort for 4
months, followed 2 month later by bilateral foot pain when
walking.
• Self medicated with ibuprofen decided to visit her family
physician:
– Complains of stiffness after awakening (2 hours), which
improves gradually through the day
– Has difficulty turning faucets
– Sleep disturbed by pain
13. • Normal physical examination, except for:
– 3 swollen proximal interphalangeal (PIP) joints on the right hand and 4
on the left
– Feet tender to palpation without obvious synovitis
– Compression of metatarsophalangeal (MTP joints causes pain (positive
squeeze test)
14. • Laboratory values:
– ESR: Elevated
– CRP: Normal
– RF: Negative
– Anti-CCP: Positive
– ALT/AST: Normal
• X-ray of hands, feet and wrists
– Soft tissue swelling most apparent around PIP and MCP joints in the index and middle
fingers
Provisional Diagnosis
?
15. In a survey of 168 RA patients, there was a
median delay of 12 weeks before a patient
was assessed in primary care
A key reason RA patients are seen late by
rheumatologists is that patients delay talking
about symptoms with their PCP
Early identification of RA can improve the
long term outcome of the disease
16. 3
2
1
Steps
Refer
•Direct the patient to the
appropriate specialist
•Relay important patient
assessment information
Identify
•Identify the signs and
symptoms of RA
•Perform a clinical
examination
Evaluate
•Order baseline and diagnostic
lab/imaging tests
•Provide a provisional
diagnosis
17. • Rheumatoid arthritis can be difficult to diagnose in its early stages because
the early signs and symptoms mimic those of many other diseases.
Identify:
•Perform a physical exam to
check joints for swelling, redness
and warmth, reflexes and muscle
strength.
Evaluate:
• Order X-rays to track the progression of
RA in joints over time.
•Order ESR or sed rate test. People with RA
tend to have an elevated erythrocyte
sedimentation rate, which indicates
inflammatory process in the body.
•Order blood tests looking for RA factor and
anti-cyclic citrullinated peptide (anti-CCP)
antibodies.
•Perform preliminary diagnosis.
18. • There is no cure for RA.
• Medications can reduce
inflammation in joints in
order to relieve pain and
prevent or slow joint damage.
• Occupational and physical
therapy can teach how to
protect joints.
• Surgery may be necessary if
joints are severely damaged
by RA.
19. • Many drugs used to treat RA have potentially serious side effects.
NSAIDs
•Non-steroidal anti-
inflammatory drugs
relieve pain and reduce
inflammation.
•Side effects may include
ringing in ears, stomach
irritation, heart
problems, and liver and
kidney damage.
Steroids
•Corticosteroid
medications, such as
prednisone, reduce
inflammation and pain
and slow joint damage.
•Side effects may include
thinning of bones,
cataracts, weight gain
and diabetes.
•The goal is gradually
tapering off the
medication.
Disease-modifying anti-
rheumatic drugs
(DMARDs)
• Slow the progression of RA
and save the joints and other
tissues from permanent
damage.
• Include methotrexate,
hydroxychloroquine
(Plaquenil)
• Side effects vary but may
include liver damage, bone
marrow suppression and
severe lung infections.
20. Immunosuppressants
• Examples include
azathioprine (Imuran)
•Can increase susceptibility to
infection.
TNF-alpha inhibitors
• Tumor necrosis factor-alpha is an
inflammatory substance produced
by the body.
• TNF-alpha inhibitors can help
reduce pain, morning stiffness,
and tender or swollen joints.
• Examples include etanercept
(Enbrel), infliximab (Remicade),
adalimumab (Humira),
golimumab (Simponi) and
certolizumab (Cimzia).
• Potential side effects include
nausea, diarrhea, hair loss and an
increased risk of serious
infections.
Other drugs
•Target a variety of processes
involved with inflammation
in the body.
•Include anakinra (Kineret),
abatacept (Orencia),
rituximab (Rituxan),
tocilizumab (Actemra) and
tofacitinib (Xeljanz).
•Side effects vary but may
include itching, abdominal
pain, headache, runny nose
or sore throat.
21. • Education
• Physical therapies /exercises
• Surgery: May help restore the ability to use joints, reduce pain and correct
deformities.
Total joint
replacement: Surgeon
removes the damaged
parts of the joint and
inserts a prosthesis
made of metal and
plastic.
Tendon repair:
Inflammation and joint
damage may cause
tendons around the
joint to loosen or
rupture. Surgeon may
be able to repair the
tendons around the
joint.
Joint fusion. Surgically
fusing a joint may be
recommended to
stabilize or realign a
joint and for pain relief
when a joint
replacement isn't an
option.
1 2 3
22. • Physiotherapy treatment is important in helping patients with RA manage
their disease.
• In conjunction with occupational therapists, physiotherapists can educate
patients in:
Performance of
therapeutic
exercises
Use of
assistive
devices
Joint
protection
strategies
23. • Rest and splinting, using compressive gloves, assistive
devices, and adaptive equipment, have beneficial effects in
managing RA symptoms and deformities.
24. Rest
The joints should be put into rest at a
functional position during the acute
stage of the disease: shoulder joint in
45⁰ abduction, both wrist joints in
20⁰ to 30⁰ dorsal flexion, fingers
slightly in flexion, hips at 45⁰
abduction without any flexion, knees
totally extended, and feet in a
neutral position.
Splinting
Orthosis and splinting are used to
diminish pain and inflammation, to
prevent development of deformities,
to prevent joint stress, to support
joints, and to decrease joint stiffness.
Various reports have shown benefits
of wrist splints in controlling
pain/inflammation and increases
hand grip strength by 20% to 25%.
25. • Patients have reported reduced joint swelling and increased well-being
however, there is no positive evidence regarding improved grip strength or
hand functions from using gloves.
• Gentle compression is beneficial because of the containment of joint
swelling and subsequent decrease of pain.
26. Examples
Loading over the hip joint may be reduced by
50% by holding a cane
Elevated toilet seats, widened gripping
handles, etc. might facilitate the daily life
Assistive Devices
Reduce functional deficits, diminish pain, and keep patients’ independence and self-efficiency
Occupational Therapy
Improves functional ability in patients with RA
Have beneficial effects on joint protection and
energy conservation in arthritic patients
28. • Muscle weakness in patients with RA may occur because of immobilization
or reduction in activities of daily living.
• Maintenance of normal muscle strength is important not only for physical
function but also for stabilization of the joints and prevention of traumatic
injuries.
29. Whether the involvement of the joints is local or systemic
Stage of the disease
Age of the patient
Compliance of the patient with the therapy
ROM exercises, stretching, strengthening, aerobic
conditioning exercises, and routine daily activities may be
used as components of exercise therapy
30. Swimming,
walking, and
cycling with
adequate
resting periods
increase
muscle
endurance and
aerobic
capacity
Chronic stage
Should avoid
activities such
as climbing
stairs or weight
lifting
Active arthritis
Isometric
exercises
provide
adequate
muscle tone.
Moderate
contractures
should be held
for 6 seconds
and repeated
5-10 times
each day.
Acute arthritis
31. • In patients with RA, sociopsychological factors affecting the disease process
such as poor social relations, disturbance of communication with the
environment, and unhappiness and depression at work are commonly
encountered.
• All clinics that deal with the treatment of RA should provide education and
information to their patients about their condition and the various physical
therapy and rehabilitative options that are available to improve their quality
of life.
32. Improve our patient quality of life
Final Goal:
Early
Diagnosis
Prevent
irreversible
joint damage
Diminish
long term
complications
Improve outcome
and patient
functionality