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Dr. Fahim Khan MBBS,MD,MRCP(UK),FRCPLondon,FRCP Edin, FACP Rheum CONSULTANT RHEUMATOLOGIST Aut Even Hospital, Kilkenny Whitfield Clinic Waterford,The St.

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Presentation on theme: "Dr. Fahim Khan MBBS,MD,MRCP(UK),FRCPLondon,FRCP Edin, FACP Rheum CONSULTANT RHEUMATOLOGIST Aut Even Hospital, Kilkenny Whitfield Clinic Waterford,The St."— Presentation transcript:

1 Dr. Fahim Khan MBBS,MD,MRCP(UK),FRCPLondon,FRCP Edin, FACP Rheum CONSULTANT RHEUMATOLOGIST Aut Even Hospital, Kilkenny Whitfield Clinic Waterford,The St Francis Hospital, Mullingar,. E mail:

2 TYPES OF ARTHRITIS NON INFLAMMATORY- DEGENERATIVE ARTHRITIS (OSTEOARTHRITIS) INFLAMMATORY ARTHRITIS- RHEUMATOID ARTHRITIS PSORIATIC ARTHRITIS GOUT ANKYLOSING SPONDYLITIS ARTHRITIS ASSOCIATED WITH INFLAMMATORY BOWEL DISEASE TICK BORN ARTHRITIS---LYME DISEASE LUPUS ARTHRITIS AND CONNECTIVE TISSUE DISORDERS POLYMYALGIA RHEUMATICA AND GIANT CELL ARTERITIS

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4 Osteoarthritis

5 Osteoarthritis knees

6 RHEUMATOID ARTHRITIS

7 Psoriatic arthritis with DIP joint involvement

8 PSORIATIC ARTHRITIS

9 Gout

10 Gout

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12 Lyme Disease

13 Osteoporosis

14 Fibromyalgia

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16 Malar Rash SLE

17 Vasculitis

18 Raynauds---Systemic sclerosis

19 DERMATOMYOSITIS

20 GCA ► headache

21 Rheumatoid Arthritis AND NEW TREATMENTS ► A prevalence of 0.5-1% in diverse population worldwide, ► Annual incidence of /1000 in males and /1000 in females. ► Cause unknown

22 Rheumatoid Arthritis SYMPTOMS ► Morning stiffness of over an hour affecting joint ► Arthritis of Hands ► Arthritis in at least three joint areas, wrists, fingers etc ► Symmetric arthritis ► Rheumatoid nodules

23 Pain, swelling and stiffness

24 RHEUMATOID HAND BOUTTONAIRES DEFORMITY SWAN NECK DEFORMITY

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26 RHEUMATOID ARTHRITIS MRI WRIST COLOUR DOPPLERS SYNOVITIS

27 Damage from Rheumatoid Arthritis Joint erosions with deformities/poor quality of life skin ulcers(leg ulcers) skin ulcers(leg ulcers) Eye complications Lung fibrosis Kidney involvement( Nephrotic syndrome- Amyloidosis) Stomach ulcers Anaemia, stomach ulcers, gastric bleeding Pins and needles hands, carpal tunnel syndrome,peripheral neuropathy And many more

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29 Rheumatoid Arthritis complications

30 Can we prevent this damage?

31 Disease modifying antirheumatic drugs therapy(DMARDs) AND BIOLOGICS ► Methotrexate ► Sulphasalazine ► Leflunomide ► Hydroxychloroquine Biologics( injections) ► Anti-TNF Alpha therapy,Infliximab, Eternacept, Adalimumad, Golimumab. ► Anti B Cell CD 20 Ab--Rituximab ► IL-1 receptor antagonist –Anakinra,Anti IL6 therapy-- Tocilizumab ► CTL4-Ig- Abatacept disrupts CD80/86 signal required for T-cell activation ► And many more noval therapies to come

32 Current TNF Blockers in RA TNF THERAPY

33 CURRENT APPROACH TO Rheumatoid Arthritis. ► Education (News papers,Journals, Radio, TV, GP, Public/ Community Meetings and more Education) ► Earlier recognition of symptoms patient---GP ► Earlier referral to specialist (Rheumatologist) ► Early Arthritis clinics (AUT EVEN HOSPITAL KILKENNY) Aiming to see patient within one week of referral. ► Earlier initiation of DMARD therapy perhaps earlier use of Biologics ► More and more research

34 Thank You Dr Fahim Khan Consultant Rheumatologist Suite 6, The Ballinderry Clinic Suite 6, The Ballinderry Clinic St Francis Private Hospital, Mullingar.


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