课件：类风湿关节炎患者健康教育.ppt

* * Rheumatoid arthritis: hand, fusiform swelling Soft-tissue swelling is an early finding in rheumatoid arthritis and usually appears as typical fusiform or spindle-shaped enlargement of the proximal interphalangeal joints. The second and third fingers of this patient are most involved. These proximal interphalangeal joints are tender and have a limited range of motion. * * 5-C-19 Rheumatoid arthritis: subcutaneous nodule, olecranon鹰嘴　 A large subcutaneous nodule is located on the extensor surface of the forearm near the elbow. Rheumatoid nodules may be fixed or movable and are usually nontender. They occur most commonly at the elbow but may also be found on the feet, fingers, occiput, heels, and buttocks. Nodules occur in about 20% of patients with rheumatoid arthritis and are usually associated with high titers of rheumatoid factor. Subcutaneous nodules are also seen in other conditions such as systemic lupus erythematosus and mixed connective tissue disease. * * 5-R-21 Rheumatoid arthritis: pulmonary nodules (roentgenogram) Large nodules are seen in the pulmonary parenchyma bilaterally. These nodules are discrete and similar in appearance to opacities caused by metastatic disease. They are histologically identical to subcutaneous rheumatoid nodules. * * Rheumatoid arthritis: vasculitis and gangrene, fingers Atrophy and gangrene are present on the tip of the middle finger. Less extensive necrotic lesions appear at the ends of the fourth and fifth fingers. These digital infarcts are caused by inflammatory occlusion of small arteries. Similar appearing lesions may occur in polyarteritis, other connective tissue diseases, embolic illnesses, diabetes mellitus, and other conditions. * * Rheumatoid arthritis: scleromalacia perforans This eye demonstrates several rheumatoid scleral nodules, scleral thinning, and adjacent conjunctival injection. The uveal tissue is about to herniate through the softened sclera in the midsuperior portion of the eye, which could re