344564
Rheumatoid
Arthritis
- primarily in
synovial tissue,
phagocystosis in
joint
- CM's - joint pain, swelling,
warmth, erythema, lack of
function, spongy/baggy tissue
on palpation, joint stiffness (esp
in am), synovial
fluid cloudy/milky/dark yellow
- DX - X-ray shows bony
erosions & narrowed joint
spaces, rheumatoid
nodules, joint infl on
palpation, lab findings:
ESR incr, rheumatoid
factor (3/4 of pt's), RBC &
C4 complement decr,
- Treatment/meds
- Early (moderate erosive) -
aggressive, education,
rest/exercise, agency referral,
salicylates/NSAID's, methotrexate
(standard), DMARD's within 3
months of onset (antimalarials,
gold, penicillamine, sulfasalazine)
- persistent erosive -
reconstructive surgery
(arthroplasty), corticosteroids,
- advanced unremitting -
immunosuppressive
agents (rheumatrex,
cytoxan, imuran, arava),
antidepressants,
Prosorba (medical
device)
- Nutrition therapy - high
vitamin/protein/iron foods
- Early (moderate erosive) -
aggressive, education,
rest/exercise, agency referral,
salicylates/NSAID's, methotrexate
(standard), DMARD's within 3
months of onset (antimalarials,
gold, penicillamine, sulfasalazine)
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