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Image transcription text Question 4: Explain what is happening in the body to cause Sarah’s decreased range of movement in her fingers. One Paragraph (200 £ 10%) Conten… Show more Sarah Jones, a 62-year-old female, has been diagnosed with rheumatoid arthritis (RA), a chronic autoimmune disorder primarily affecting the joints. RA is characterized by persistent inflammation, which Sarah has been experiencing as joint pain in her fingers, wrists, and hips, along with morning stiffness lasting over an hour. These symptoms are indicative of the disease’s progressive nature, leading to difficulty in daily activities such as buttoning clothes and buttering toast. The pathophysiology of RA involves the immune system mistakenly attacking the synovium, the lining of the joints. This autoimmune reaction triggers the release of pro-inflammatory cytokines like tumor necrosis factor (TNF) and interleukin-6 (IL-6), which promote inflammation and lead to the thickening of the synovium, forming a pannus. The pannus invades and erodes cartilage and bone, causing joint damage, deformity, and immobility. In Sarah’s case, her blood tests showed elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, indicating systemic inflammation. Additionally, the presence of rheumatoid factor (RF), anti-citrullinated peptide/protein antibodies (ACPA), and autoantibodies confirmed by ANA results, along with genetic predisposition (positive HLA-DRB1), further supported the RA diagnosis. Her x-rays revealing mild deformities in the proximal interphalangeal joints confirm the joint damage typical of RA.

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