Registered Nurse (RN)
Medical Surgical Nursing & Pathophysiology
Musculoskeletal Disorders
Rheumatoid Arthritis Assessment

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Rheumatoid Arthritis Assessment

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Rheumatoid Arthritis Assessment

Roman King-Arthur and Assess-man
Rheumatoid Arthritis (RA) is a chronic, systemic autoimmune disease characterized by inflammation of connective tissue in the diarthrodial (synovial) joints with periods of remission and exacerbation. There is an increased incidence in women and while RA can occur at any age, it peaks between the ages of 30 and 50 years. Symptoms include joint stiffness, pain, and limitation of movement with the physical presentation of nodules and possibly joint deformities.
Destruction of Connective Tissue and Synovial Membrane
Destruction of Connected Tissue-boxes and Sun-oval Membrane

Rheumatoid arthritis occurs as a result of the immune system attacking the synovium (the lining of membranes surrounding joints). This destruction of connective tissue and the synovial membrane results in the following signs and symptoms.

Inflammation of Joints
Joints in Flames

Signs of inflammation, such as heat, swelling, and tenderness, occur symmetrically and commonly affect the small joints of the hands (PIP and MCP) and feet (MTP). Larger joints such as the wrists, elbows, shoulders, knees, hips, ankles, and jaw can also be involved. The joints may become painful, tender, and warm to the touch. This pain can intensify with motion and may not be proportionate to the degree of inflammation.

Morning Stiffness
Stiff-board with Morning-sun

Morning stiffness may last from 60 minutes to several hours or more, depending on disease activity. Joint stiffness commonly occurs after periods of inactivity.


Rheumatoid nodules are firm bumps of tissue located on extensor surface of joints.

Joint Deformities
Joint Deformities

Over time, joint deformities may develop as inflammation and fibrosis of the joint capsules and supporting structures progresses. Common distortions of the hand include ulnar drift, boutonniere, and swan neck deformities.


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