RHEUMATOID

ARTHRITIS
DEFINITION

Rheumatoid
arthritis,achronic,
systemic,
inflammatory
autoimmune
disease,hasasits
primarytargetthe
synovialtissues.
ETIOLOGY
Thedefinitcauseofrheumatoidarthritisis
unknown,becauseitisverycomplicatedandthe
scientistisstilldoingthesurveilance,butthe
mechanisminpathologycanconcludeseveralcauses
ofRA

immune
regulatoryfactors
Gene

Smoking
andotherformsof
environment
bronchialstress
Sexhormone Androgen

Infection Abnormal
imunerespon
EPIDEMIOLOGY
InIndonesia,the
prevalenceisunder0,4%.
Incentraljavathe
Thehigh prevalenceisabout0.2%,
prevalencefound inMalang0,5%.
inPimaIndian InRSCipto
MangunkusumoJakarta,
andChippewa
insidensofRAfrom
Indian,about januaryuntilJune2007is
5,3%and6,8% about203case.

Thecaseis
usuallyfoundin
woman
 PATHOLOGY

Jointdamageoccurswhenthelimfosit,macrofagandfibroblas
areoccurinthesynovialtissues

Inflammationandoclusiofartery

Irregulartissue

Breakdownthecartilago

progressivedisabilityinmovement
Thediseaseoftenbegins
slowly,usuallywithonly
minorjointpain,stiffness,
andfatigue.

RAusuallyaffectswrists,
fingers,knees,feet,and
ankles.
 SYMTOPMATHOLOGY
Mainsymptoms:
Morningstiffness,whichlastsmorethan1hour,iscommon.
Jointsmayfeelwarm,tender,andstiffwhennotusedforanhour.
Jointpainisoftenfeltonthesamejointonbothsidesofthebody.
Overtime,jointsmaylosetheirrangeofmotionandmaybecome
deformed.

Othersymptoms:

Chestpainwhentakingabreath(pleurisy)
Dryeyesandmouth(Sjogrensyndrome)
Eyeburning,itching
Noduleundertheskin(usuallyasignofmoreseveredisease)
Numbness,tingling,orburninginthehandsandfeet
Sleepdifficulties
 DIAGNOSIS
Sevendiagnosticcriteria:
1. morningstiffness,
2. arthritisofthreeormorejointareas,
3. arthritisofthehandjoints
4. symmetricarthritis,
5. rheumatoidnodules,
6. elevatedlevelsofserumrheumatoidfactor,
7. Radiographicchanges.

thefirstfourcriteriamustbepresent
foraminimumofsixweeksbeforeadiagnosisofrheumatoidarthritis
canbemade

WecanuseCreactiveprotein(CRP),EritrositSedimentRate(ESR),Joint
xraytohelpusmakediagnosis
THERAPHY/TREATMENT

Nonsteroidalantiinflammatorydrugs(NSAIDs)
Corticosteroids(glucocorticoid)
Diseasemodifyingantirheumaticdrugs(DMARD):methotrexate