Rheumatic Diseases
conditions that affects joints, muscles, and soft
tissues of the body.
Autoimmunity: where the body mistakenly recognizes
its own tissue as a foreign antigen.
Classification:
-Monoarticular or polyarticular
-Inflammatory or noninflammatory
Characteristics:
• Inflammation
• Autoimmunity
• Degeneration
RHEUMATOID ARTHRITIS
Chronic, progressive inflammatory disease that can
affect tissues and organs but principally attacks the
joints, producing inflammatory synovitis.
Pathophysiology
Autoimmune disease precipitated by WBC attacking
synovial tissue.
• Inflammation can extent to cartilage, bone,
tendons and ligaments that surround the joint.
• It is also a systemic disease that can affect any
connective tissue in the body. (Blood vessels,
pleura surrounding lungs, and pericardium; iritis
and scleritis in the eyes.
• If diagnosed and treated early, it is possible to
avoid permanent joint damage.
Risk Factors:
• females
• Age 30-60
• Genetic predisposition
• Bacterial or viral infection (Epstein-Barr virus)
• Stress and smoking
• Environmental factors
• Older age
• Obesity
Clinical Manifestations:
• Initial: symmetric joint pain, morning stiffness
(longer than an 1 hr), swelling, warmth,
erythema and lack of function.
• Palpation of joints reveals spongy or boggy
tissue.
• Begins in small joints of hands, wrisssts and
feet.
• As progresses: the knees, shoulders, hips,
elbows, ankles, cervical spine and
temporomandibular joints get affected.
Symptoms bilateral and symmetric.
Patient tends to guard or protect these joints by
immobilizing them. (Long term immob leads to
contractures).
• Deformities of hands: ulnar deviation and
swan neck deformity, and boutonniere
deformity.
•Lymph node enlargement
• Raynaud’s phenomenon: cold-and stiff
cyanosis digitalis
RHEUMATIC DISEASES
Chapter 34
