RHEUMATOID

ARTHRITIS
DEFINITION

Rheumatoid
arthritis, a chronic,
systemic,
inflammatory
autoimmune
disease, has as its
primary target the
synovial tissues.
ETIOLOGY

The definit cause of rheumatoid arthritis is unknown,

because it is very complicated and the scientist is still
doing the surveilance, but the mechanism in
pathology can conclude several causes of RA

immune
regulatory factors
Gene

Smoking
and other forms of
environment
bronchial stress
Sex hormone Androgen

Infection Abnormal
imune respon
EPIDEMIOLOGY
In Indonesia, the
prevalence is under 0,4%.
In central java the
The high prevalence is about 0.2%,
prevalence found in Malang 0,5%.
in Pima Indian In RS Cipto
Mangunkusumo Jakarta,
and Chippewa
insidens of RA from
Indian, about january until June 2007 is
5,3% and 6,8% about 203 case.

The case is
usually found in
woman
 PATHOLOGY

Joint damage occurs when the limfosit,macrofag and fibroblas

are occur in the synovial tissues

Inflammation and oclusi of artery

Irregular tissue

Breakdown the cartilago

progressive disability in movement

The disease often begins
slowly, usually with only
minor joint pain, stiffness,
and fatigue.

RA usually affects wrists,

fingers, knees, feet, and
ankles.
 SYMPTOMS
Main symptoms:
•Morning stiffness, which lasts more than 1 hour, is common.
•Joints may feel warm, tender, and stiff when not used for an hour.
•Joint pain is often felt on the same joint on both sides of the body.
•Over time, joints may lose their range of motion and may become
deformed.

Other symptoms:

•Chest pain when taking a breath (pleurisy)

•Dry eyes and mouth (Sjogren syndrome)
•Eye burning, itching
•Nodule under the skin (usually a sign of more severe disease)
•Numbness, tingling, or burning in the hands and feet
•Sleep difficulties
 DIAGNOSIS
Seven diagnostic criteria:
1. morning stiffness,
2. arthritis of three or more joint areas,
3. arthritis of the hand joints
4. symmetric arthritis,
5. rheumatoid nodules,
6. elevated levels of serum rheumatoid factor,
7. Radiographic changes.

the first four criteria must be present

for a minimum of six weeks before a diagnosis of rheumatoid arthritis
can be made

We can use C-reactive protein (CRP),Eritrosit Sediment Rate (ESR), Joint

x-ray to help us make diagnosis
THERAPHY / TREATMENT

Nonsteroidal anti inflammatory drugs (NSAIDs)

Corticosteroids (glucocorticoid)
Disease-modifying antirheumatic drugs (DMARD) : methotrexate