Rheumatoid Arthritis Manifestations Quiz
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Questions and Answers

What is the typical age range for the onset of Rheumatoid Arthritis?

  • First to third decades of life
  • Can occur at any age
  • Third to sixth decades of life (correct)
  • Seventh to ninth decades of life

    • Which of the following joints is the most commonly involved in Rheumatoid Arthritis?

  • Metatarsophalangeal (MTP) joints of the feet
  • Shoulder joints
  • Metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the hands (correct)
  • Elbow joints

    • What is the characteristic pathological finding in the joints of patients with Rheumatoid Arthritis?

  • Persistent inflammatory synovitis
  • Cartilage damage
  • Bone erosions
  • All of the above (correct)

    • Which of the following is an extra-articular manifestation of Rheumatoid Arthritis?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a characteristic clinical feature of Rheumatoid Arthritis?

    <p>Morning joint stiffness lasting more than 1 hour, with improvement after physical activity</p> Signup and view all the answers

    Which of the following is NOT a common extra-articular manifestation of rheumatoid arthritis?

    <p>Osteoarthritis</p> Signup and view all the answers

    Which of the following laboratory findings is NOT typically associated with rheumatoid arthritis?

    <p>Thrombocytopenia</p> Signup and view all the answers

    Which of the following is a characteristic radiographic feature of advanced rheumatoid arthritis?

    <p>Joint destruction and collapse</p> Signup and view all the answers

    Which of the following is NOT a required criterion for the diagnosis of rheumatoid arthritis according to the 1987 ACR criteria?

    <p>Presence of rheumatoid nodules</p> Signup and view all the answers

    Which of the following is the most characteristic joint involvement pattern in early rheumatoid arthritis?

    <p>Symmetric polyarthritis</p> Signup and view all the answers

    What score is needed for the classification of a patient as having definite Rheumatoid Arthritis according to the 2010 ACR/EULAR criteria?

    <p>6/10</p> Signup and view all the answers

    How many large joints need to be involved to score 2 points in the Joint Involvement category of the 2010 ACR/EULAR criteria?

    <p>6-10 large joints</p> Signup and view all the answers

    Which of the following serology results would score 3 points in the Serology category of the 2010 ACR/EULAR criteria?

    <p>High-positive RF or high-positive ACPA</p> Signup and view all the answers

    Which combination of acute-phase reactants results in scoring 1 point in the Acute-phase Reactants category of the 2010 ACR/EULAR criteria?

    <p>Abnormal CRP or normal ESR</p> Signup and view all the answers

    How long must Criteria 1-4 be present to meet the diagnosis of Rheumatoid Arthritis?

    <p>At least 6 weeks</p> Signup and view all the answers

    Which of the following joints are NOT involved in Rheumatoid Arthritis?

    <p>Sacroiliac joints</p> Signup and view all the answers

    Which of the following factors is NOT associated with a higher likelihood of developing extra-articular manifestations in Rheumatoid Arthritis?

    <p>Late-onset disease</p> Signup and view all the answers

    Which of the following is NOT an extra-articular manifestation of Rheumatoid Arthritis?

    <p>Gout</p> Signup and view all the answers

    Which of the following laboratory tests is NOT commonly used in the evaluation of Rheumatoid Arthritis?

    <p>Anti-double-stranded DNA antibodies</p> Signup and view all the answers

    Which of the following is NOT a characteristic feature of Rheumatoid Arthritis?

    <p>Acute onset of joint pain and swelling</p> Signup and view all the answers

    Study Notes

    Rheumatoid Arthritis

    • Systemic, autoimmune rheumatic disease affecting approximately 1% of the population.
    • Chronic multisystem disease of unknown cause, characterized by persistent inflammatory synovitis leading to cartilage damage, bone erosions, joint deformity, and disability.

    Onset

    • Most commonly affects people in the third to sixth decades.
    • Female: male ratio is 3:1.
    • Initial pattern of joint involvement can be polyarticular, oligoarticular, or monoarticular.
    • Morning joint stiffness > 1 hour and easing with physical activity is characteristic.
    • Small joints of hand and feet are typically involved.

    Clinical Manifestations

    Articular

    • Pain in affected joint aggravated by movement is the most common symptom.
    • Morning stiffness ≥1 hour.
    • Joints involved:
      • MCP and PIP joints of hands (90%)
      • MTP of feet (80%)
      • Knees, ankles, and wrists (60%)
      • Shoulders, elbows, TM, acromio-clavicular, and SC joints (50%)
      • Cervical spine ( Instability can lead to impingement of the spinal cord)

    Extra-articular

    • Present in 30-40% of patients.
    • May occur prior to arthritis.
    • Patients more likely to get extra-articular manifestations:
      • High titres of RF and ACPA
      • HLA DR4+
      • Male
      • Early onset disability
      • History of smoking
    • Extraarticular manifestations include:
      • Constitutional symptoms (most common)
      • Rheumatoid nodules (30%)
      • Hematological, respiratory, CVS, CNS, eye, and rheumatoid vasculitis

    Laboratory Investigations

    • CBC: TLC, DLC, Hb, ESR, and GBP
    • Acute phase reactants
    • Rheumatoid Factor (RF)
    • Anti-CCP antibodies (ACPA)

    Rheumatoid Factor (RF)

    • Antibodies that recognize Fc portion of IgG
    • Can be IgM, IgG, or IgA
    • 85% of patients with RA over the first 2 years become RF+

    ACR Criteria (1987)

      1. Morning Stiffness ≥1 hour
      1. Arthritis of ≥3 joints observed by physician
      1. Arthritis of hand joints
      1. Symmetric arthritis
      1. Rheumatoid nodules
      1. Positive Rheumatoid Factor
      1. Radiographic Erosions or periarticular osteopenia in hand or wrist joints
    • Criteria 1-4 must be present for ≥6 weeks
    • Must have ≥4 criteria to meet diagnosis of RA

    2010 ACR/EULAR Classification Criteria

    • Score of ≥6/10 is needed for classification of a patient as having definite RA
    • A. Joint involvement SCORE
      • 1 large joint
      • 2-10 large joints
      • 1-3 small joints (with or without involvement of large joints)
      • 4-10 small joints (with or without involvement of large joints)
      • >10 joints (at least 1 small joint)
    • B. Serology (at least 1 test result is needed for classification)
      • Negative RF and negative ACPA
      • Low-positive RF or low-positive ACPA
      • High-positive RF or high-positive ACP
    • C. Acute-phase reactants (at least 1 test result is needed for classification)
      • Normal CRP and normal ESR
      • Abnormal CRP or normal ESR
    • D. Duration of symptoms

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    Related Documents

    Rheumatoid Arthritis Presentation PDF

    Description

    Test your knowledge on the manifestations of rheumatoid arthritis including extra-articular symptoms, risk factors, and clinical presentations. Learn about the involvement of different joints and common features associated with the disease.

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