DR Medhat MRCP

Extra-articular manifistations
Skin : subcutaneous rheumatoid nodules
Respiratory:
1. Pulmonary fibrosis
2. Pleural effusion
3. Pulmonary nodules
4. Bronchiolitis obliterans.
5. Pleurisy
6. Methotrexate pneumonitis
7. Caplan's syndrome :
(i.e massive fibrotic nodules with occupational coal dust exposure)
Ocular (25%):
سؤال common) 1. Keratoconjunctivitis sicca (most
2. Episcleritis (erythema)
سؤال pain) 3. Scleritis (erythema +
4. Corneal ulceration
5. Keratitis
6. Steroid-induced cataracts
7. Chloroquine retinopathy
Osteoporosis.
ISCHEMIC heart disease: هام سؤال RA carries a similar risk to T2DM.
Increased risk of infections.
Depression.
Scleritis
Less common:
1. Felty's syndrome (RA + splenomegaly + low white cell count).
2. Amyloidosis.
• Investigations :
1) Rheumatoid factor (RF) : (+ve in 75% 0f cases).
(70-80% sensitive)
2) Anti CCP Abs : (Highly specific > RF,90-95%)
(70-80% sensitivity)
3) Plain x-ray : Bone erosions.
Bone displacement.
Corneal ulceration & keratitis
سؤال هام Periarticular osteopenia & osteoporosis
Loss of jont space (in exam , more characteristic to OA).
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