TUTORIAL KLINIK

RHEUMATOID ARTHRITIS

Oleh: Brian Umbu Rezi Depamede

H1A212013

DALAM RANGKA MENGIKUTI KEPANITERAAN KLINIK MADYA

DI BAGIAN/SMF RADIOLOGI
RUMAH SAKIT UMUM PROVISI NTB
FAKULTAS KEDOKTERAN UNIVERSITAS MATARAM
2017
DEFINISI

Rheumatoid arthritis (RA) adalah penyakit autoimun

peradangan multisistemik kronis yang mempengaruhi
banyak organ namun sebagian besar menyerang
jaringan sinovial dan persendian.
Penyebab dari RA belum diketahui. Pemicu eksternal
(misalnya, merokok, infeksi, atau trauma) yang memicu
reaksi autoimun.
GEJALA KLINIS

Nyeri
Demam
Malaise
Artralgia
Lemah
Radang dan pembengkakan pada sendi tangan dan
kaki
ANATOMI
MODALITAS RADIOLOGI

Rontgen
MRI
USG
 RONTGEN

Widespread osteopenia,
carpal crowding (due to
cartilage loss), and several
erosions affecting the carpal
bones and metacarpal heads
in particular in a child with
advanced juvenile rheumatoid
arthritis (also known as juvenile
idiopathic arthritis).
 RONTGEN

Subluxation in the
metacarpophalangeal joints, with
ulnar deviation, in a patient with
rheumatoid arthritis of the hands.
 RONTGEN

Soft-tissue swelling and early erosions in

the proximal interphalangeal joints in a
patient with rheumatoid arthritis of the
hands.
 RONTGEN

Moderate to severe
tricompartmental uniform
loss of joint space bilaterally.
 RONTGEN

Anteroposterior radiograph of
the knee shows uniform joint-
space loss in the medial and
lateral knee compartments
without osteophytosis. A Baker
cyst is seen medially
(arrowhead).
 RONTGEN

There are marginal erosions of

the 3rd-5th metacarpal heads
on the left, and 4th and 5th
metacarpal heads on the right.
There is also a uniform loss of
joint space at these locations,
as well as at the 2nd
metacarpophalangeal joint on
the right, and
metacarposesamoid
articulations bilaterally.
 RONTGEN

Ankylosis in the cervical spine at

several levels due to long-
standing juvenile rheumatoid
arthritis (also known as juvenile
idiopathic arthritis).
 RONTGEN

Lateral view of the cervical

spine in a patient with
rheumatoid arthritis shows
erosion of the odontoid
process.
 RONTGEN

Lateral flexion view of

the cervical spine shows
atlantoaxial subluxation.
 MRI

Coronal, T1-weighted
magnetic resonance
imaging scan shows
characteristic pannus and
erosive changes in the wrist
in a patient with active
rheumatoid arthritis.
 MRI

T1-weighted sagittal magnetic

resonance image of the cervical spine
shows basilar invagination with cranial
migration of an eroded odontoid peg.
There is minimal pannus. The tip of the
peg indents the medulla, and there is
narrowing of the foramen magnum
due to the presence of the peg.
Inflammatory fusion of several cervical
vertebral bodies is shown.
 MRI

Sagittal T2-weighted magnetic

resonance image of cervical spine in
same patient as in previous image.
Compromised foramen magnum is
easily appreciated, and there is
increased signal intensity within upper
cord; this is consistent with compressive
myelomalacia. Further narrowing of
canal is seen at multiple levels.
 USG

Ultrasonography-guided
synovial biopsy of the second
metacarpophalangeal joint of
the right hand in a patient with
rheumatoid arthritis of the
hands. The biopsy needle is
seen as a straight echogenic
line on the left side of the image
in an oblique orientation.
 DAFTAR PUSTAKA

https://radiopaedia.org/articles/rheumatoid-arthritis
http://emedicine.medscape.com/article/331715