Arthritis, Rheumatoid

Arthritis, Rheumatoid is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Chronic systemic inflammatory disorder that attacks the joints:
    • Nonsuppurative, proliferative synovitis
    • Destruction of the articular cartilage
    • Ankylosis of the joint
  • Involvement of knee is common.
  • Baker cysts may be seen in chronic disease.
  • Involvement of spine is limited to cervical region:
    • May cause atlantoaxial subluxation
    • Rarely results in cord compression

Pediatric Considerations
Juvenile rheumatoid arthritis (JRA) is a distinct entity (see “Arthritis, Juvenile Idiopathic”).
  • Genetics:
    • Genetic predisposition related to HLA-DR4
    • Female-to-male ratio is 3:1.
    • Typical age of onset is between 30 and 50.

Etiology

  • Etiology is unknown.
  • Possible triggers include infection and autoimmune response.
  • Prevalence is about 1% of both US and world population.

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