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Rheumatoid Arthritis Extra-articular Signs

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Rheumatoid Arthritis Extra-articular Signs

  • Epidemiology
  1. Extra-articular findings in 20-40% of Rheumatoid Arthritis patients
  • Risk Factors
  • Extra-articular RA findings
  1. Male Gender
  2. Seropositive (RF, ACPA, ANA)
  3. Tobacco abuse
  • Findings
  • Common Extra-Articular
  1. Rheumatoid Nodules
  2. Profound Fatigue
  3. Low-grade fever
  4. Weight loss
  5. Normochromic Normocytic Anemia
  • Findings
  • Other Extra-Articular
  1. Cardiovascular
    1. Accelerated Coronary Artery Disease (leading cause of death in RA)
    2. Pericarditis
    3. Pericardial Effusion
    4. Rheumatoid Nodules in Great Vessel or Myocardium wall
      1. Causes Heart Block and Bundle Branch Block
    5. Systemic Vasculitis
  2. Lung
    1. Pulmonary Nodules
    2. Pleural Effusion (very low Pleural FluidGlucose)
    3. Caplan Syndrome (Lung Nodules, pneumoconiosis)
    4. Interstitial Lung Disease
  3. Ophthalmologic manifestations
    1. Keratoconjunctivitis Sicca (common)
    2. Episcleritis or Scleritis
    3. Peripheral Ulcerative Keratitis
    4. Scleromalacia
  4. Neurologic manifestations
    1. Rheumatoid granulomata near nerve roots
    2. Cervical Spine subluxation at C1-2 (with secondary cervical myelopathy)
      1. Results from Rheumatoid Arthritis erosions
    3. Neuropathy (e.g. Carpal Tunnel, mononeuritis multiplex)
  5. Hoarseness (extreme and progressive)
    1. Rheumatoid changes in laryngeal cricoarytenoid joints
  6. Felty Syndrome