H & P

Joint Pattern Note:

• No shoulder and hip involvement
• No lumbar spine involvement
• NEVER DIP involvement

EAM:

• Eyes: !Scleritis, Episcleritis
• Skin: Rheumatoid Nodules
• Lung: ILD - Interstitial Lung Disease → CTD-associated ILD
• Felty: Neutropenia ↓, Splenomegaly

Physical Exam Signs

• Wrist and Hand Joint Exam
  • MCP Swelling – sign of inflammatory activity (Early)
  • MCP Subluxation – sign of damage (Late)
  • Swan-neck deformity
  • Boutonniere deformity
  • Ulnar Deviation

Investigations

• CVD - Atherosclerosis
• OA - Osteoarthritis
• Lymphoma