II. Epidemiology
- Extra-articular findings in 20-40% of Rheumatoid Arthritis patients
III. Risk Factors: Extra-articular RA findings
- Male Gender
- Seropositive (RF, ACPA, ANA)
- Tobacco Abuse
IV. Findings: Common Extra-Articular
- Rheumatoid Nodules
- Profound Fatigue
- Low-grade fever
- Weight loss
- Normochromic Normocytic Anemia
V. Findings: Other Extra-Articular
- Cardiovascular
- Accelerated Coronary Artery Disease (leading cause of death in RA)
- Pericarditis
- Pericardial Effusion
- Rheumatoid Nodules in Great Vessel or Myocardium wall
- Causes Heart Block and Bundle Branch Block
- Systemic Vasculitis
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Lung
- Pulmonary Nodules
- Pleural Effusion (very low Pleural FluidGlucose)
- Caplan Syndrome (Lung Nodules, pneumoconiosis)
- Interstitial Lung Disease
- Ophthalmologic manifestations
- Keratoconjunctivitis Sicca (common)
- Episcleritis or Scleritis
- Peripheral Ulcerative Keratitis
- Scleromalacia
- Neurologic manifestations
- Rheumatoid Granulomata near nerve roots
- Neuropathy (e.g. Carpal Tunnel, mononeuritis multiplex)
- Cervical Spine involvement (up to 80% of patients)
- Cervical Spine subluxation at C1-2 (up to 25 to 40% of patients)
- Risk of secondary Cervical Myelopathy from central spinal stenosis
- Results from Rheumatoid Arthritis erosions and inflammation
- Affects odontoid process, transverse ligament, alar ligament, C1 lateral mass
- References
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Hoarseness (extreme and progressive)
- Rheumatoid changes in laryngeal cricoarytenoid joints
- Felty Syndrome