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Rheumatoid Arthritis and Osteoarthritis

Rheumatoid Arthritis and Osteoarthritis. D efinition A etiology P athophysiology S igns and Symptoms I nvestigations C omplications A lternative Diagnosis M anagement P rognosis. Definition.

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Rheumatoid Arthritis and Osteoarthritis

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  1. Rheumatoid Arthritis and Osteoarthritis

  2. Definition AetiologyPathophysiologySigns and SymptomsInvestigationsComplicationsAlternative Diagnosis Management Prognosis

  3. Definition • RA: - an autoimmune disease- results in a chronic, systemic inflammatory disorder - principally affects flexible (synovial) joints

  4. Definition • OA: - a degenerative non-inflammatory disorder- degradation of articular cartilage and subchondral bone- ‘wear and tear’- m/c affects the spine

  5. Aetiology

  6. Pathophysiology • RA: - not well understood- autoimmunity with environmental triggers- abnormal immune function response • OA:- chronic degenerative disorder- trauma - related to but NOT CAUSED by ageing H2O content of cartilage Cartilage is less resilient +- inflammation of joint capsule +- new bony outgrowths develop

  7. Signs and Symptoms of RA • Joint: pain, stiffness, swollen, hot • Loss of joint function • Symmetrical polyarthritis • Pain worse in morning (>1hr) • Pain improves with movement • Fatigue • Anaemia of chronic disease

  8. Signs and Symptoms of OA • Joint: pain, stiffness • Loss of joint function • NO swelling • Pain better with slight use but worse with excessive or prolonged movement • Crepitus

  9. Investigations • History and examination • X-ray • CT/MRI • Bloods • Assay analysis

  10. Complications

  11. Alternative Diagnosis • Gout • Pseudogout • SLE (RA) • Psoriatic arthritis • Reactive arthritis

  12. Management of RA • Conservative: -Regular exercise - Patient education • Medical: - DMARDs - NSAIDs(+ after 3/12) • Surgical: - Arthroscopic/Open Synovectomy - Joint replacement - + Post-operative physiotherapy

  13. Management of OA • Conservative: -Light exercise - Patient education - Weight loss if necessary • Medical: - Paracetamol - NSAIDs • Surgical: - Joint replacement

  14. Prognosis • RA:- Progressive- Rh nodules  worse prognosis - Atherosclerosis- 3-12 year lifespan reduction • OA:- Progressive- Majority have no severe disability- Knee OA  worst prognosis- Hand OA  best prognosis

  15. Any Questions?

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