Rheumatoid arthritis

Autoimmune, inflammatory disorder.

Affects synovial joints with formation of the pannus --- MCP, PIP.

----Subcutaneous rheumatoid nodules

----Ulnar deviation

----Subluxation

----Baker's  cyst ------under the knee

Females are most commonly involved than males

Type III hypersensitivity reaction

Majority have "  +  " Rheumatoid Factor (anti-IgG antibody)

HLA-DR4

        Classic picture:       

---morning joint stiffness for more than 30 minutes, that improves with use.

---SYMMETRIC joints involvement

---SYSTEMIC symptoms: fever, fatigue, pleuritis, pericarditis

     Treat:

---NSAID

---COX-2 inhibitors

---glucocorticoids

---disease-modifying drugs:

     Methotrexate, 

     Sulphasalazine, 

     Hydroxychloroquine