类风湿关节炎RheumatoidArthritis.pptxVIP

类风湿关节炎Rheumatoid Arthritis (RA) 郑州大学第一附属医院 By Raoul Dufy (1877-1953)OutlineDefinition and historyPrevalanceEtiology,pathogenesis and pathologyClinical featuresLaboratory findingsImagingDiagnosis and differential diagnosisManagement RA定义An autoimmune disorder of unknown etiology characterized by symmetric, erosive synovitis and, in some cases, extraarticular involvement. Most patients experience a chronic fluctuating course of disease that, despite therapy, may result in progressive joint destruction, deformity, disability, and even premature death-----2003, American college of Rheumatology历史Medicine as an artThe holy family with St. Anne(C1633—C1635) by Peter Paul RubensOn the Terrace (1878)By Pierre-Auguste RenoirHistory :Pierre-Auguste Renoir (1841-1919)历史： Erik WaalerThe occurrence of a factor in human serum activating the specific agglutination of sheep corpuscles. Acta Pathol Microboil Scand 1940; 1: 172-88.Erik WaalerDRB1Genetic Factors in RAVirus-infection HypothesisSex Hormone on RARheumatoid Pannus（血管翳）Pannus （血管翳）Rheumatoid Arthritis: Hand, Fusiform Swelling（梭形）Ulnar（尺侧） Deviation and Muscle AtrophySwan Neck Deformity and Boutonnière Deformity钮扣花Telescoping SignArthritis Mutilans残毁Arthritis MutilansHypermobility Arthritis MutilansSubcutaneous Nodule, Olecranon鹰嘴Rheumatoid NodulesRheumatoid Nodules in the LungRheumatoid Nodule: PathologyScleromalacia Perforans（穿孔性巩膜软化）Vasculitis and Gangrene（坏疽）Extensor Tendon RupturePopliteal Cyst（腘窝囊肿）3/198911/19903/199211/19936/19961/1995Progressive Right PIP3 Erosions in a 60-year Old Lady Suffering From RA3/1989Right Wrist in the Same Patient3/198911/19903/19923/198911/19903/199211/19936/199611/19936/19961/19951/1995Rheumatoid Arthritis: KneesHip, Late ErosionsProtrusio Acetabuli髋臼突出患病率病因 遗传因素感染因素内分泌因素发病机理病理Synovitis(滑膜炎）VasculitisRheumatoid nodules临床表现关节表现晨僵　Morning stiffness关节痛Arthralgia 和关节压痛 tenderness关节肿 Joint swelling 关节变形 Joint deformity关节外表现A Picture is Worth a Thousand Words关节外表现类风湿结节 Rheumatoid nodule类风湿血管