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Rheumatoid arthritis

Created: 9/11/2004



  • Involvement of temporomandibular joints
  • Cervical spine fixed/subluxed and therefore can be unstable
  • Cricoarytenoid involvement should be suspected if hoarse voice present

Respiratory system

  • Costochondral involvement may cause a restrictive deficit and decreased tidal volume
  • Interstitial fibrosis can cause a V/Q mismatch

Cardiovascular system

  • Coronary arteritis
  • Conduction abnormalities
  • Immobility may obscure underlying symptoms of cardiovascular system disease


  • Chronic anaemia often present
  • Treatment with non-steroidal anti-inflammatory drugs can cause gastrointestinal blood loss

Renal failure

  • May be caused by amyloidosis or chronic drug treatment

Steroid therapy

  • Steroid cover needed
  • Postoperative infection can occur


  • Full blood count, urea & electrolytes, chest X-ray, cervical spine X-ray, ECG, pulmonary function in some cases

Conduct of anaesthesia

  • Careful positioning
  • Difficult intubation set ready
  • Awake fibreoptic if necessary
  • Regional blockade preferable

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