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Cheatography

Seropositive Arthropathies - RA Cheat Sheet (DRAFT) by

Imaging findings + clinical features

This is a draft cheat sheet. It is a work in progress and is not finished yet.

RA - Clinical Features

- Young - middle aged females
+ve RF/ RA latex
Elevated ESR
Anaemia
Fever
Fatigue
Weight Loss
Muscle Soreness
Muscle Atrophy
Fusifo­rm/­spindle like swelling
Stiffness
Can be variable

Radiology

Synovial Oedema = Soft tissue Swelling
Rheumatoid Nodule = Subcut­aneous Soft Tissue Mass
Cartilage Destru­ction = Uniform Loss of Joint Space
Pannus Eroding Bone = Marginal Erosions "Rat bite"
Intrao­sseous Pannus and Synovial Fluid Intrusion = Subchr­ondral Cysts
Inflam­matory Hyperemia = Juxtaa­rti­cular Osteop­orosis
Fibrous Tissue Metaplasia = Ankylosis
Capsule, Tendon, Ligament laxity + rupture = Deformity (Swan neck & Bouton­niere)
Bouton­niere = Flexion of the PIPs and Extension of the DIPs
Swan Neck = Extension of the PIPs and flexion of the DIPs

Mangement of RA

- NSAIDs
- Cortic­ost­eroids
- DMARDs
- Conven­tional DMARDs
- Biological Therapies (Anti-TNF)
- Joint replac­ements if severe

RA - Sites

RA affects the
Hands, Wrist, Feet, Knee, Hip, Cx Spine
In the Hands, RA affects the:
MCPs, PIPs (1st), Carpals, ulnar styloid, Radioc­arpal joint in a bilateral symmet­rical fashion

RA of the Cx Spine

- Atlant­o-axial instab­ility & impaction
Dens Erosion
- Pts who have RA in their feet and hands are more likely to suffer of Cx compli­cations
- Decreased Disc Height
- Apophyseal Joint Disease
- Spinous Process Erosion
- Sublux­ation
- Osteop­orosis

Juvenile RA

- Inflam­matory Arthro­pathy <16 yo
2 Main types + 3 subtypes
RF + - Worst prognosis
 
RF - (Still's disease: Muscle wasting, fever, fatigue)
 
Classic - Systemic Organ Involv­ement
 
Polyar­ticular - Bilateral + Symmet­rical- fewer systematic S&S
 
Paucia­rti­cul­ar/­Mon­oar­ticular - <4 joints, Likes large joints

Juvenile RA Findings

- Soft Tissue Swelling
- Osteop­orosis
- Loss of Joint Space
- Articular Erosions
- Sublux­ations
- Growth Distur­bances + perios­titis Ankylosis in children

Systemic Lupus Erythe­matosis

- Rheumatoid Type (serop­osi­tive)
- Females (child bearing)
- ESR Elevated
- LE cells present
- ANA positive
- Marked Sublux­ation

Clinical Findings

- Malaise, Fever, Skin Rash, Arthra­lgias
- Elevated ESR, ANF, LE , RF +

Radiog­raphic Findings

- Bilateral, Symmetric reversible deform­ities
- Osteop­orosis
- Soft Tissue Atrophy
- Increased Incidence of AVN in Hip
- Hand most commonly affected
- Increase in ADI
- Ulnar Deviation
- NO EROSIONS COMPARED TO RA