Professional Documents
Culture Documents
DEFINITIE
Leziunea elementara sinovita inflamatorie
Distructia articulara
Pusee evolutive
Caracter heterogen
SN
SP
Macrofage
Ly T
Macrofage
Ly T
Neu
Macrofage
Ly T
Neu
Macrofage
Ly B
Neu
Ly T
Macrofage
Plasmocite
Ly B
Neu
Ly T
Macrofage
CIC + C
Plasmocite
Ly B
Neutrofile
Ly T
Macrofage
Complexe imune circulante +
Complement
Plasmocite
Ly B
Neu
Ly T
Macrofage
CIC + C
Plasmocite
Ly B
EPIDEMIOLOGIE
Cea mai frecventa - colagenoze
F:H 3:1
Debut 50 ani
Prevalenta 0.3 - 0.8 %
PR
PR la debut !!!
PR
PR la debut !!!
Artrite
PR
Poliartrita
Bilaterala
Simetrica
+/ manifestari extra-articulare
PR
Poliartrita
Bilaterala
Simetrica
+/ Manifestari extraarticulare
Puseu evolutiv
Distrugeri structurale
PR
Poliartrita
Monoartrita
Bilaterala
Simetrica
Caracter inflamator
Oligoartrita
+/ Manifestari extra-
PR
Pumnul/RC
MCP (II;III)
IFP
IFD
PR MANIFESTARI ARTICULARE
Deviatie dg. bataia vantului
Deformare in gat de
lebada
Deformare in butoniera"
Degete in ciocan
Police in Z
Luxatia stiloidei radiale in
clapa de pian
Picior plat in valgus
PR MANIFESTARI ARTICULARE
Deviatie dg. bataia vantului
Deformare in gat de lebada
Deformare in butoniera"
Degete in ciocan
Police in Z
Luxatia stiloidei radiale in clapa
de pian
Picior plat in valgus
PR MANIFESTARI ARTICULARE
Deviatie dg. bataia
vantului
Deformare in gat de
lebada
Deformare in butoniera"
Degete in ciocan
Police in Z
Luxatia stiloidei radiale in
clapa de pian
Picior plat in valgus
PR MANIFESTARI ARTICULARE
Deviatie dg. bataia
vantului
Deformare in gat de
lebada
Deformare in butoniera"
Degete in ciocan
Police in Z
Luxatia stiloidei radiale in
clapa de pian
Picior plat in valgus
PR MANIFESTARI ARTICULARE
Deviatie dg. bataia
vantului
Deformare in gat de
lebada
Deformare in butoniera"
Degete in ciocan
Police in Z
Luxatia stiloidei radiale in
clapa de pian
Picior plat in valgus
PR MANIFESTARI ARTICULARE
Deviatie dg. bataia vantului
Deformare in gat de lebada
Deformare in butoniera"
Degete in ciocan
Police in Z
Luxatia stiloidei radiale in clapa
de pian
Picior plat in valgus
PR MANIFESTARI ARTICULARE
Deviatie dg. bataia vantului
Deformare in gat de
lebada
Deformare in butoniera"
Degete in ciocan
Police in Z
Luxatia stiloidei radiale in clapa
de pian
Picior plat in valgus
ART. SH
ART. SH
Artrita glenohumerala
Capsulita retractila
Nu abductie
Eroziuni ale partii distale ale
claviculei + ruptura calotei
rotatorilor
ART. SH
Artrita glenohumerala
Capsulita retractila
Nu abductie
Eroziuni ale partii distale ale
claviculei + ruptura calotei
rotatorilor
BURSITE
BURSITE
CHIST BAKER
PR - MANIFESTARI EXTRAARTICULARE
Febra
Astenie
Stare de rau
PR - MANIFESTARI EXTRAARTICULARE
Noduli reumatoizi
Fermi
Mobili
Indolori
MTX
PR - MANIFESTARI EXTRAARTICULARE
Les infections
pleuropulmonaire
La fibrose pulmonaire
interstitielle diffuse - MTX
Les bronchectasies
PR - MANIFESTARI EXTRAARTICULARE
Amiloidoza AA
Proteinurie
Sindrom nefrotic
Insuficienta renala progresiva
PR - MANIFESTARI EXTRAARTICULARE
Amiloidoza AA
Proteinurie
Glomerulonefrita
interstitiala
Glomerulonefrita
extramembranara
Sindrom nefrotic
Insuficienta renala
progresiva
PR - MANIFESTARI EXTRAARTICULARE
Anemie
Splenomegalie
Leuconeutropenie
Sindromul Felty
Trombocitopenie
Hepatomegalie
Pseudosindromul Felty /
limfocitoza cu limfocite
granulomatoase
FR +
AAN +
Infectii
PR - MANIFESTARI EXTRAARTICULARE
Anemie
Splenomegalie
Leuconeutropenie
Sindromul Felty
Trombocitopenie
Hepatomegalie
Pseudosindromul Felty /
limfocitoza cu limfocite
granulomatoase
FR +
AAN +
Infectii
PR - MANIFESTARI EXTRAARTICULARE
Livedo reticular
Purpura vasculara
Ulcere profunde
Necroze digitale
Vasculita leucocitoclastica
Neuropatie periferica
PR LABORATOR
Hemoleucograma + FP
VS
PCR
Bilant hepatocelular
Creatinina
Sumar de urina
PR LABORATOR
FR
Anti CCP
AAN
PR LABORATOR
FR
Anti CCP
Ig M
Specificitate 75 - 85%
Sensibilitate 70 % - 80%
AAN
Manifestari extraarticulare
Prognostic
PR LABORATOR
Ig G
FR
Specificiate 75 - 85%
Anti CCP
AAN
50% PR
Prognostic
PR LABORATOR
FR
Anti CCP
15 30 %
AAN
LED
PR EXPLORARI IMAGISTICE
Radiografia toracelui
Radiografie comparativa maini
Radiografia pumnului fata
Radiografie comparativa picioare
Radiografia coloanei cervicale
PR EXPLORARI IMAGISTICE
Radiografia toracelui
Radiografie comparativa maini
Radiografia pumnului fata
Eroziuni periarticulare
Geode juxta-articulare
Pensarea interliniului articular
http/pio.arthrolink.com/radiotheque
http/pio.arthrolink.com/radiotheque
PR EXPLORARI IMAGISTICE
Radiografia toracelui
Radiografie comparativa maini
Radiografia pumnului fata
Radiografie comparativa picioare
Radiografia coloanei cervicale
Compresia medulara
PR EXPLORARI IMAGISTICE
ECOGRAFIE
RMN
PR EXPLORARI IMAGISTICE
ECOGRAFIE
Eroziuni
Sinovite
RMN
Tenosinovite
Rupturi tendinoase
EROZIUNI
EROZIUNI
SINOVITE
TENOSINOVITE
TENOSINOVITE
PR EXPLORARI IMAGISTICE
ECOGRAFIA
IRM
http/pio.arthrolink.com/radiotheque
http/pio.arthrolink.com/radiothequ
e
http/pio.arthrolink.com/radiotheque
http/pio.arthrolink.com/radiotheque
Redoare matinala 1 h.
Serologie (0-3)
FR, CCP
6 saptamani
PR FACTORI DE PROGNOSTIC
FR +
Anti-CCP +
VSH
PCR
NAD
NAT
Statut socio-economic
Non aderenta la tratament
PR FACTORI DE PROGNOSTIC
FR +
Anti-CCP +
VSH
PCR
NAD
NAT
Statut socio-economic
Non aderenta la tratament
DAQ 28 3.2
SDAI
CDAI
HAQ 0.5
PR TRAITEMENT
Remisiune
NAD 1
NAT 1
PCR 1 mg/dl
VSH 1 (0-10)
PR TRATAMENT
Remisiune
Control al durerii
Nivel scazut de
activitate!
evolutie
PR TRATAMENT
Remisiune
Control al durerii
Nivel scazut de
activitate!
evolutie
PR TRATAMENT SIMPTOMATIC
Anti inflamatoare non
steroidiene / AINS
Anti inflamatoare steroidiene /
AIS
Fizioterapie
Reeducare
Orteze
Corticoizi
PR TRATAMENT SIMPTOMATIC
PR TRAITEMENT SYMPTOMATIQUE
Anti inflammatoires non
stroidiennes / AINS
Anti inflammatoires
stroidiennes / AIS
Physiothrapie
Reducation
Orthses
Corticoides
PR TRATAMENT
Remisia
Control al durerii!!!
Activitate scazuta
a bolii!!!
evolutie
Hidroxicloroquina/P
laquenil