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Rheumatoid Arthritis is progressive (symmetrical) form of autoimmune arthritis, usually involving the small joints of the hands and/ or feet.
All of these inflammatory arthritis diseases are systemic in nature. They affect multiple systems and we need to know the relationship between the different systems and the different conditions that they might be related to.


If you want to learn more about this topic, you can watch Jack March's lecture here:

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Here are some systems that can be affected and related in rheumatology:

Musculoskeletal system

Typically rheumatoid arthritis affects the synovium of the small joints, the MCPJs and the MTPJs of the hands and feet. But what also happens with rheumatoid arthritis is, it can also affect the tendons. So we get things like tenosynovitis as well, and there is a bit of an overlapping picture with regards to the joint and the tendon. In conditions like axial spondyloarthritis, ankylosing spondylitis and psoriatic arthritis which are primarily enthesitic disorders the inflammatory process is affecting the enthesis of joints, where the tendon blends to bone and that’s where the inflammatory reaction occurs.

Integumentary system

In spondyloarthritis usually psoriasis occurs and in some connective tissue disorders we find rashes. About 1 in 4 patients with psoriasis go on to develop some form of related arthritis. The more severe the skin psoriasis is, the more likely they are going to develop an arthritis.

Digestive system

When we consider the digestive system, it's mostly Crohn’s disease or Ulcerative Colitis which occurs. These diseases are related to spondyloarthritis. There's about a 1 in 4 chance of developing an arthritis within 6 years of Crohn’s disease diagnosis.

Ocular system

In the ocular system, we are usually looking for iritis and uveitis. These are acute inflammatory conditions of the eye which are very common. It’s estimated approximately 50% of people who attend emergency clinic for their eye with uveitis have an undiagnosed spondyloarthritis.

Neurological system

Typically, rheumatoid arthritis, spondyloarthritis, they're not affecting the neurological system particularly, but lupus does. There are various types of lupus. They're all quite complex and they can affect the neurological system.

Cardiovascular system

Rheumatoid arthritis and spondyloarthritis do affect the cardiovascular system, but this is much further down the disease. They do not present at the time of their onset of symptoms with cardiovascular symptoms. But the ongoing inflammation over a long period of time does affect, especially the blood vessels, causes atherosclerosis and may lead to strokes and heart attacks. But this is after 30 or 40 years of having rheumatoid arthritis.

Reproductive system

The other thing that we’re looking for in connective tissue disorders is the reproductive system being affected. There is a component of lupus which is called antiphospholipid syndrome, which causes miscarriages in women. So what we would be looking for typically would be a widespread type pain syndrome, but also on the background of multiple miscarriages.

Watch this clip from the lecture ‘Rheumatology Red Flags’ by Jack March on Trust me-Ed to know how multiple systems are involved in RA.

If you want to learn more about this topic, you can watch Jack March's lecture here:

Click here



1. Lecture ‘Rheumatology Red Flags’ by Jack March on Trust me-Ed

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