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Dr. Fahim Khan MBBS,MD,MRCP(UK), FRCPLondon,FRCP Edin , FACP Rheum

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: rheumatologyclinics@gmail.com . . TYPES OF ARTHRITIS. NON INFLAMMATORY-

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Dr. Fahim Khan MBBS,MD,MRCP(UK), FRCPLondon,FRCP Edin , FACP Rheum

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  1. Dr. Fahim KhanMBBS,MD,MRCP(UK),FRCPLondon,FRCPEdin, FACP Rheum CONSULTANT RHEUMATOLOGIST Aut Even Hospital, Kilkenny Whitfield Clinic Waterford,The St Francis Hospital, Mullingar, . E mail: rheumatologyclinics@gmail.com .

  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

  3. Osteoarthritis

  4. Osteoarthritis knees

  5. RHEUMATOID ARTHRITIS

  6. Psoriatic arthritis with DIP joint involvement

  7. PSORIATIC ARTHRITIS

  8. Gout

  9. Gout

  10. Lyme Disease

  11. Osteoporosis

  12. Fibromyalgia

  13. Malar Rash SLE

  14. Vasculitis

  15. Raynauds---Systemic sclerosis

  16. DERMATOMYOSITIS

  17. GCA • headache

  18. Rheumatoid Arthritis AND NEW TREATMENTS • A prevalence of 0.5-1% in diverse population worldwide, • Annual incidence of 0.1-0.2/1000 in males and 0.2-0.4/1000 in females. • Cause unknown

  19. Rheumatoid ArthritisSYMPTOMS • 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

  20. Pain, swelling and stiffness

  21. SWAN NECK DEFORMITY RHEUMATOID HAND BOUTTONAIRES DEFORMITY

  22. RHEUMATOID ARTHRITIS MRI WRIST COLOUR DOPPLERS SYNOVITIS

  23. Damage from Rheumatoid Arthritis Joint erosions with deformities/poor quality of life 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

  24. Rheumatoid Arthritis complications

  25. Can we prevent this damage?

  26. Disease modifying antirheumaticdrugs 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

  27. Current TNF Blockers in RA TNF THERAPY

  28. CURRENT APPROACH TORheumatoid 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

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

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