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RHEUMATOID ARTHRITIS

Rheumatoid arthritis is a systemic autoimmune rheumatic disorder of unknown etiology.
It is the most common form of inflammatory arthritis.
Patient usually complains of joint pain and/or swelling with morning stiffness that lasts for more than an hour.

Goals of treatment are clinical and radiological remission of disease and to reduce functional limitations and permanent joint damage.

Rheumatoid%20arthritis Signs and Symptoms

Signs and Symptoms

Introduction

Rheumatoid arthritis (RA) is a chronic inflammatory arthritis of unknown etiology
- Most common autoimmune inflammatory arthritis in adults
- Persistent synovitis leads to joint destruction and deformity

Signs and Symptoms

General

Joint pain and/or swelling
Morning stiffness lasting ≥1 hour
Myalgia, fatigue, weight loss, low-grade fever, depression
Typically involves the joints of the fingers, wrists, toes
- Upper and lower extremity joints are also affected (eg shoulders, elbows, knees and ankles)
Syndrome of polymyalgia rheumatica may occasionally be present

Early Rheumatoid Arthritis

Duration of occurrence of rheumatoid arthritis signs and symptoms is <6 months and meets the classification criteria of rheumatoid arthritis

Established Rheumatoid Arthritis

Duration of occurrence of rheumatoid arthritis signs and symptoms is ≥6 months and meets the classification criteria of rheumatoid arthritis

Palindromic Rheumatism

Follows an episodic pattern
- Joints may be affected for hours to days followed by symptom-free periods lasting for days to months

Undifferentiated Arthritis

May indicate onset of a polyarticular disease
- Interval between monoarthritis and polyarthritis may extend from days to weeks in patients with progressive disease
Large joints are frequently affected (eg shoulder, wrist, hip, knee, ankles)
History of joint trauma may be the initiating event

Extra-articular Involvement

Anemia, fatigue, pleuropericarditis, interstitial lung disease, neuropathy, scleritis, Sjogren’s syndrome, vasculitis
Subcutaneous rheumatoid nodules on extensor surfaces of elbows and over Achilles tendons
Splenomegaly

Etiology

Smoking increases incidence for developing rheumatoid arthritis in anti-citrullinated protein antibody (ACPA)-positive patients
Bacteria (eg Escherichia coli, Helicobacter pylori, Mycobacteria, Mycoplasma, Streptococcus), viruses (eg Epstein-Barr virus, rubella, parvovirus) and periodontal disease (Porphyromonas gingivalis) is strongly associated with the occurrence of rheumatoid arthritis

Weight loss by either surgery or diet key to better metabolic health in diabetes

Jairia Dela Cruz, 22 hours ago

For individual with type 2 diabetes, losing weight is everything when it comes to improving the metabolic function, and it matters little whether this is achieved by dieting or undergoing bariatric surgery, according to a small study.

PCI tied to death, MI, stroke in patients with LMCA, LV dysfunction

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Percutaneous coronary intervention (PCI), compared with coronary artery bypass grafting (CABG), in the revascularization of left main coronary artery (LMCA) disease may lead to death, myocardial infarction (MI), or stroke in patients with moderate or severe left ventricular (LV) dysfunction, reveals a study.