Physical examination of rheumatoid arthritis

PREPARED BY: MUHAMMAD ARIFF B. MAHDZUB

BACHELOR MEDICINE AND SURGERY (MBBS)
UNIVERSITY COLLEGE SHAHPUTRA, KUANTAN

1. 1 Physical Examination of Rheumatoid Arthritis PROBLEM BASED LEARNING (PBL) PREPARED BY: MUHAMMAD ARIFF B. MAHDZUB BACHELOR MEDICINE AND SURGERY (MBBS) UNIVERSITY COLLEGE SHAHPUTRA, KUANTAN

2. Signs & Symptoms In most patients with RA, onset is insidious, often beginning with fever, malaise arthralgias Weakness before progressing to joint inflammation and swelling

3. Signs and symptoms of rheumatoid arthritis may include the following: Persistent symmetric polyarthritis ( synovitis ) of hands and feet (hallmark feature) Progressive articular deterioration Extra- articular involvement Difficulty performing activities of daily living (ADLs) Constitutional symptoms

4. P hysical examination should address the following : Upper extremities ( metacarpophalangeal joints, wrists, elbows, shoulders) Lower extremities (ankles, feet, knees, hips) Cervical spine

5. During the physical examination, it is important to assess the following: Stiffness Tenderness Pain on motion Swelling Deformity Limitation of motion Extra- articular manifestations Rheumatoid nodules

6. LAB INVESTIGATIONS

7. Antinuclear antibody (ANA) Commonly found in the blood of people who are having auto immune disease. This test can be used to confirm the diagnosis of arthritis .

8. Rheumatoid factor (RF) detect and measure the level of an antibody, positive in people with rheumatoid arthritis .

9. HLA tissue typing detects the presence of certain genetic markers in the blood, can confirm a diagnosis of ankylosing spondylitis (a disease involving inflammation of the spine and sacroiliac joint) or Reiter’s syndrome (a disease involving inflammation of the urethra, eyes and joints). The genetic marker HLA-B27 is almost always present in people with either of these diseases.

10. Erythrocyte sedimentation rate   t his test measures how fast red blood cells cling together, fall and settle (like sediment) in the bottom of a glass tube over an hour. The higher the rate, the greater the amount of inflammation.