my hands are aching

Demography
1. Farida
2. 45 years old
3. clinical presentation
  1. pain in the hand
    1. hand joints
      1. wrist joint
      2. CMC
      3. MCP
      4. IP
    2. hand bones
      1. Radius
      2. Ulna
      3. carpal bones
        Scaphoid
        lunate
        triquitrum
        pisiform
        trapezium
        trapezoid
        capitate
        hamate
        carpal tunnel
        flexor retinacula
        Flexor digitorum P and S tendons
        Median nerve
        Flexor polices longus tendon
        Flexor carpi radialus
      4. metacarpal
      5. phalanx
Rheumatoid arthritis
1. Autoimmune disease
  1. immunology
    1. pannus formation
      1. lymphocytes
      2. macrophages
      3. plasma cells
      4. neutrophils
      5. mast cells
      6. cytokines
    2. failure of tolerance
      1. central
        Thymus
      2. peripheral
        T reg cells
  2. causes
    1. genetics
    2. environmental factors
2. affecting the whole body
  1. joints
    1. synovial membrane
      1. synovial fluid
  2. kidney
  3. eyes
  4. Bones
    1. osteoporosis
3. Symptoms
  1. pain
  2. swelling
4. diagnosis
  1. criteria
    1. RF+
      1. IgM
      2. Binds to
        IgG(Anti-DNA)-DNA complex
        damages the
    2. symmetrical arthritis
    3. 3 or more joints
    4. morning pain >1 hr
    5. arthritis of hand joints
    6. rheumatoid nodules
    7. radio changes erosions
      1. Xray
        findings
        Ulnar deviation of MCP
        Swan neck deformity
        Butonierre deformity
    8. periarticular osteopenia
    9. FOR >6 weeks
5. Treatment
  1. NSAIDs
  2. DMARDs
  3. BIO therapies
  4. corticosteroids

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my hands are aching

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	Criado por Omran Alowais quase 6 anos atrás