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Rheumatoid Arthritis Vs Osteoarthritis PowerPoint Presentation

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Description : This medical presentation titled "Rheumatoid Arthritis Vs Osteoarthritis" provides us information on Rheumatoid Arthritis and Osteoarthritis.

Tags : Rheumatoid Arthritis, Treatment options, chronic systemic autoimmune inflammatory disease, aggressive inflammatory changes, synovium, joint pain, stiffness, swelling, joint damage, functional debility, Osteoarthritis, Symptoms, Signs

Published on : Apr 26, 2021 | Views : 2231 | Downloads : 36

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Slide 1-

Rheumatoid ArthritisVsOsteoarthritis Anusha Reddy FY1 General Surgery (UHCW)
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Rheumatoid Arthritis Definition Multisystem Autoimmune Inflammatory Condition Symmetrical Polyarthropathy Small joints
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Epidemiology It can develop at any age, but typically starts between 40- 60 years Female:Male (3:1) Common Arthritis: 1 in 100 develop RA at some stage in their life
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Pathophysiology Not completely elucidated! Autoimmune Trigger Synovial cell hyperplasia and endothelial cell activation  uncontrolled inflammation  bone destruction Genetics
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Symptoms and Signs Morning stiffness lasting ≥1 hour* Swelling in ≥3 joints* Swelling in hand joints* Symmetric joint swelling* Erosions or declacifications on xray of hand Rhematoid nodules Abnormal serum RF *Must be present ≥6 weeks
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Extra-articular manifestations
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Investigations Bloods FBC, U&Es, LFTs, ESR, CRP, RF anti CCP Imaging
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Management Conservative- weight loss, smoking cessation, OT Pain relief- paracetamol + NSAIDS, Steroids Disease modification – DMARDs and Biologics (Etanercept + Adalimumab)
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DMARDS METHOTREXATE (first line)- oral ulcers, alopecia, GI upset, hepatotoxic SULFASALAZINE- GI upset, less hepatotoxic LEFLUNOMIDE- Liver cirrhosis, GI upset, alopecia !GOLD- Rash, Glomerulonephropathy !PENICILLIAMINE- Rash, lupus-like illness
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Case 1 34 F presents 8/52 history of pain of the small joints in her hand. Pain worse first thing in the morning Associated with stiffness +++ Takes around 1 hours for the stiffness to go away Feels more tired than usual Notices swollen hands
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Case 1 Social History Works as a secretary and has been late for work- pain has disrupted her morning routine Smokes 15 cigarettes/day Drinks <10units of wine/week
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Case 1 On Examination Slightly swollen over the MCP and PIP joints of both hands. Tender +++ No obvious deformity Temp 37.5°C Injected right eye- non tender Skin changes°/ elbows°/scalp°
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Case 1 Differential Diagnosis Rheumatoid Arthritis Osteoarthritis SLE Sjogrens Syndrome Sarcoidosis Psoriatic Arthritis Polymyalgia Rheumatica
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Case 1 Investigations ? Bloods FBC, U&Es, LFTs, ESR, CRP, (RF anti CCP) Imaging Narrowing of joint spaces Soft tissue swelling Bony erosions Subluxation Periarticular osteopenia Joint deformity
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Management Conservative- smoking cessation Drugs 1) Pain relief 2) Disease modifying Social Modifications at work Modifications at home Case 1
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Osteoarthritis Definition Degenerative joint disease A clinical syndrome of joint pain accompanied by functional limitation and reduced QOL Hips Knees Small joints of hands
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Osteoarthritis Risk factors Increasing age Women Obesity Joint injuries- sports/occupational repetitive stress load
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Symptoms and Signs Square thumb
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RA Vs. OA
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Investigation Bloods FBC, U&Es, LFTs, ESR, CRP Imaging- 4 cardinal signs on Xray? Subchondrial sclerosis Osteophytes Narrowing of joint space Subchondrial cysts
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Management Management !THINK! Function- function-function Conservative- muscle strengthening exercises + aerobic exercise Drugs- Paracetamol + NSAIDS (top/oral) Intrarticular steroid injections as adjunct therapy Surgery- indicated when PAIN/stiffness have a substantial impact on QOL MDT- Physio, OT, GP
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Osteoarthritis- !THINK! Function
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Case 2 67 F presents with pain in the joints of her hands, mainly the thumbs. Pain worse after gardening Slight swelling present Pain eased by paracetamol Hypertension (Amlodipine 5mg), retired secretary, never smoked and non-drinker
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Case 2 On examination Not grossly defomed Squaring of the thumb joint Tender over PIPs and DIPs Do her buttons and write her name with slight discomfort
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Case 2 Investigations ? Bloods FBC, U&Es, LFTs, ESR, CRP Imaging Subchondrial sclerosis Osteophytes Narrowing of joint space Subchondrial cysts
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Management
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References Nice guidelines- Rheumatoid Arthritis (2009) http://www.nice.org.uk/nicemedia/live/12131/43326/43326.pdf Nice guidelines- Osteoarthritis (2008) http://www.nice.org.uk/nicemedia/live/11926/39557/39557.pdf
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THANK YOU! ANY QUESTIONS??
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Hand Changes in RA
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Hand Changes in OA Square thumb