Question
All of the following are false about Rheumatoid arthritis, except
| A. |
PIP and DIP joints involved equally
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| B. |
Pathology limited to articular cartilage
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| C. |
Women are affected 3 times more commonly than men
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| D. |
> 75% of patients have extra articular manifestations
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Show Answer
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Correct Answer » C
Explanation
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Clinical Reasoning for the Correct Answer
– RA is a chronic systemic autoimmune disease primarily targeting the synovial membrane rather than cartilage alone.
– The inflammation in RA starts at the synovium, leading to pannus formation that erodes cartilage and underlying bone.
– Therefore, pathology extends beyond just the articular cartilage; inflammation affects the synovium, cartilage, and bone, not just cartilage.
Also
– RA typically affects the PIP and metacarpophalangeal (MCP) joints, but spares the DIP joints.
– DIP involvement is common in osteoarthritis but rare in RA.
– Thus, PIP and DIP joints are not involved equally; DIP joint involvement would suggest an alternate diagnosis.
Why Option C is Correct
– RA affects women about 3 times more frequently than men.
– This gender predilection is well documented and related to hormonal and genetic factors.
Why Option D is Incorrect
– Extra-articular manifestations occur in approximately 20-40% of RA patients.
– These can include rheumatoid nodules, lung involvement (e.g., pleuritis), vasculitis, anemia, and ocular inflammation.
