Rheumatoid Arthritis

The fetal environment potentially preprograms the brain or endocrine system to be maladapted later in life and that patients with rheumatoid arthritis are known for having a dysregulated HPA axis, which may be affected in utero.

Tumor necrosis factor α (TNF-α) inhibitor treatment for patients who have rheumatoid arthritis (RA) probably will reduce, not increase, the risk of heart failure if it effectively reduces inflammatory activity.

Patients may have difficulty distinguishing weakness and fatigue, as well as asthenia.

The wrist, a complex joint, often is involved in inflammatoryarthritis, such as rheumatoid arthritis or psoriatic arthritis. Wristsynovitis causes pain, swelling, and loss of extension. Extension of thesynovial lining may lead to synovitis of the ulnar styloid. During injectionof the ulnocarpal joint, the lidocaine and corticosteroid mixtureshould flow without resistance. Injecting air after corticosteroidinjection of the ulnar styloid creates a seal that prevents the corticosteroidfrom leaking up the needle tract into the dermal layer and creatingunsightly depigmentation. (J Musculoskel Med. 2008;25:188-189)

An 18-year-old complained of pain and decreased mobility of the small finger in his right hand after a softballinjury. While sliding back to second base during a pickoff attempt, the patient hit his hand on the bag.