Rheumatoid arthritis (RA): Extra-articular manifestations Skin: • Inflammation of skin (esp. over areas of stress) forms large necrotizing granulomas under skin -> Rheumatoid Nodules • Auto-immune attack on hair follicles -> Alopecia • Auto-immune attack on blood vessels (vasculitis) Decr delivery of blood to limbs (esp legs) -> Leg Ulcers, Livedo reticularis Blood: Anemia Eyes: • Globe inflammation (Scleritis, Episcleritis) -> Sudden eye pain, Sclera may perforate! • Lymphocytic infiltration damages tear glands -> Dry Eyes (xeropthalmia) Mouth: • Lymphocytic infiltration damage salivary glands -> Dry mouth (Xerostomia) Heart: • Inflammation of pericardium (Pericarditis) -> Chest Pain worse when supine, friction rub audible Lungs: • Inflammation of pleural membranes irritates pleural nociceptors & induces fluid extravasation -> Dyspnea, pleuritic chest pain, pleural effusion on CXR • RA inflammation tends to cause interstitial lung disease/pulmonary fibrosis (mechanism unknown) -> Dyspnea + dry cough, Crackles on auscultation #RheumatoidArthritis #RA #pathophysiology #signs #symptoms #diagnosis #ExtraArticular
