According to ICD 10, rheumatoid arthritis belongs to class M: inflammatory polyarthropathy. In addition to it, this includes JRA (juvenile or juvenile rheumatoid arthritis), gout and others. The causes of this disease are still not fully understood. There are several theories about its development, but no consensus has yet been formed. The infection is thought to cause dysregulation of the immune system in people who are predisposed to it. As a result, molecules are formed that destroy joint tissue. This theory is contradicted by the fact that rheumatoid arthritis (ICD code - 10 M05) is poorly treated with antibacterial drugs.
Rheumatoid arthritis is an ancient disease. The first cases of it were discovered during the study of Indian skeletons, whose age was about four and a half thousand years. Descriptions of RA have been found in literature since 123 AD. People with characteristic symptoms of the disease were depicted in Rubens' paintings.
Rheumatoid arthritis was first described as a nosological entity by the physician Landre-Beauvais at the beginning of the nineteenth century and called it “asthenic gout.” The disease received its current name half a century later, in 1859, when it was mentioned in a treatise on the nature and treatment of rheumatic gout. For every hundred thousand people, fifty cases are identified, most of them women. By 2010, more than forty-nine thousand people died from RA worldwide.
RA is such a common disease that it has a separate chapter in ICD 10. Rheumatoid arthritis, like other joint pathologies, is caused by the following factors:
- a tendency to autoimmune diseases in the family;
- the presence of a certain class of histocompatibility antibodies.
- measles, mumps (mumps), respiratory syncytial infection;
- the entire family of herpes viruses, CMV (cytomegalovirus), Epstein-Barr;
3. Trigger factor:
- stress, medication, hormonal imbalances.
The pathogenesis of the disease lies in the abnormal reaction of immune system cells to the presence of antigens. Lymphocytes produce immunoglobulins against body tissues instead of destroying bacteria or viruses.
According to ICD 10, rheumatoid arthritis develops in three stages. In the first stage, swelling of the joint capsules is observed, which causes pain, the temperature rises and the shape of the joints changes. In the second stage, the cells of the tissue that covers the inside of the joint begin to rapidly divide. Therefore, the synovial membrane becomes dense and rigid. In the third stage, inflammatory cells release enzymes that destroy joint tissue. This causes difficulty with voluntary movements and leads to physical defects.
Rheumatoid arthritis (ICD 10 - M05) has a gradual onset. Symptoms appear gradually and may take months. In extremely rare cases, the process can begin acutely or subacutely. The fact that articular syndrome (pain, deformation and local fever) is not a pathognomonic symptom significantly complicates the diagnosis of the disease. As a rule, morning stiffness (the inability to move the joints) lasts about half an hour, and it intensifies when attempting active movements. A harbinger of the disease is pain in the joints when the weather changes and general meteosensitivity.
There are several variants of the course of the disease, which the doctor in the clinic should focus on.
1. Classic , when joint damage occurs symmetrically, the disease progresses slowly and all its precursors are present.
2. Oligoarthritis affecting exclusively large joints, usually the knees. It begins acutely, and all manifestations are reversible within one and a half months from the onset of the disease. In this case, the pain in the joints is of a volatile nature, there are no pathological changes on the x-ray, and treatment with NSAIDs (non-steroidal anti-inflammatory drugs) has a positive effect.
3. Felty's syndrome is diagnosed if joint disease is accompanied by an enlarged spleen with a characteristic pattern of blood changes.
4. Juvenile rheumatoid arthritis (ICD 10 code – M08). A characteristic feature is that it affects children under 16 years of age. There are two forms of this disease:
— with allergic septic syndrome;
- articular-visceral form, which includes vasculitis (inflammation of the joints), damage to the heart valves, kidneys and digestive tract, as well as damage to the nervous system.
As with other nosological entities reflected in ICD 10, rheumatoid arthritis has several classifications.
1. According to clinical manifestations:
- very early, when symptoms last up to six months;
- early, if the disease lasts up to a year;
— expanded – up to 24 months;
- late - with a disease duration of more than two years.
2. X-ray stages:
- First. There is thickening and compaction of the soft tissues of the joint, and isolated areas of osteoporosis.
- Second. The process of osteoporosis affects the entire epiphysis of the bone, the joint space narrows, and erosions appear on the cartilage;
- Third. Deformation of the epiphyses of bones, habitual dislocations and subluxations;
- Fourth. Ankylosis (complete absence of joint space).
3. Immunological characteristics:
For rheumatoid factor:
- seropositive rheumatoid arthritis (ICD 10 - M05.0). This means that rheumatoid factor is detected in the patient’s blood.
- seronegative rheumatoid arthritis.
For antibodies to cyclic citrullinated peptide (Anti-CCP):
- seropositive rheumatoid arthritis;
4. Functional class:
ICD 10 classifies juvenile rheumatoid arthritis as a separate category as an autoimmune disease of young children. Most often, children get sick after a severe infectious disease, vaccination or joint injury. Aseptic inflammation develops in the synovial membrane, which leads to excessive accumulation of fluid in the joint cavity, pain, and ultimately to thickening of the wall of the joint capsule and its adhesion to the cartilage. After some time, the cartilage is destroyed and the child becomes disabled.
The clinic distinguishes between mono-, oligo- and polyarthritis. When only one joint is affected, then this is, accordingly, monoarthritis. If up to four joints are affected simultaneously by pathological changes, then this is oligoarthritis. Polyarthritis is diagnosed when almost all joints are affected. There is also systemic rheumatoid arthritis, when other organs are affected in addition to the skeleton.
In order to make a diagnosis, it is necessary to correctly and fully collect anamnesis, conduct biochemical blood tests, take x-rays of the joints, as well as serodiagnosis.
In a blood test, the doctor pays attention to the erythrocyte sedimentation rate, rheumatoid factor, and the number of blood cells. The most progressive at the moment is the detection of anti-CCP, which was isolated in 2005. This is a highly specific indicator that is almost always present in the blood of patients, unlike rheumatoid factor.
If the patient has suffered an infection or is in its midst, then specific antibacterial therapy is indicated. When selecting medications, pay attention to the severity of the articular syndrome. As a rule, they start with non-steroidal anti-inflammatory drugs and at the same time corticosteroids are injected into the joint. In addition, since RA is an autoimmune disease, the patient needs plasmaphoresis to eliminate all immune complexes from the body.
Treatment is usually long-term and can drag on for years. This is due to the fact that drugs must accumulate in the tissues. One of the key aspects of therapy is the treatment of osteoporosis. For this, the patient is asked to follow a special diet with a high calcium content (dairy products, almonds, walnuts, hazelnuts), as well as take calcium supplements and vitamin D.
Stages of disease development and degree of joint destruction
The World Health Organization (WHO) has developed a special medical coding for the diagnosis and definition of medical diseases. ICD 10 code is the coding of the international classification of diseases, 10th revision, as of January 2007.
Today, there are 21 classes of diseases, each of which contains subclasses with codes for diseases and conditions. Rheumatoid arthritis ICD 10 belongs to class XIII “Diseases of the musculoskeletal system and connective tissue”. Subclass M 05-M 14 “Inflammatory processes of polyarthropathy.”
Reactive arthritis of the knee is the most common rheumatic disease. The disease is characterized by a non-purulent inflammatory formation in the bone structure. In some cases, the disease occurs as a response to infectious diseases of the gastrointestinal tract (GIT), urinary tract and reproductive system.
The development of arthritis occurs a month after infection, but the provocative infection that caused this disease is in the human body and does not manifest itself. Men over 45 years of age are at greatest risk. Sexually transmitted infections (gonorrhea, chlamydia and others) can contribute to the progression of the disease. Women are less likely to suffer from this disease.
If the carrier of the infection enters the body through food, reactive arthritis can develop equally in both men and women.
A characteristic feature of the course of the disease is the symmetry of joint damage
Reactive arthritis has an acute form. In the first week, the patient experiences fever, gastrointestinal (GIT) disorders, acute intestinal malaise, and general weakness. Subsequently, the symptoms of arthritis progress and are of a classic nature. At this stage of development, the disease can be divided into 3 types.
Initially, the disease may affect only one knee joint, but later it can spread to other joints. The pronounced clinical manifestations can be minor or very strong depending on the person’s immune system. In the future, rheumatoid polyarthritis may develop, which affects the larger joints of the lower extremities and toes. Back pain occurs in the most severe form of the disease.
In rare cases, the disease can affect the central nervous system and cause complications in the cardiovascular system.
Today, to confirm whether a patient really has reactive arthritis, a whole range of laboratory tests is needed. Various specialists are involved in examining the patient. It is necessary to undergo an examination by a gynecologist, urologist and therapist. The attending physician will indicate the need for examination by other medical specialists. After collecting the results of laboratory tests, medical history data, and identifying clinical manifestations, the use of certain drugs is prescribed.
Treatment of reactive arthritis must begin with the destruction of the infectious focus, that is, the causative agents of the original disease. To do this, you need to undergo a comprehensive examination of the whole body. After identifying the pathogen, sensitivity to drugs is determined. A bacterial infection is treated with antibiotics.
The use of antibacterial drugs is recommended at the initial, most acute stage of the disease. In the future, their use becomes less effective. In some cases, symptomatic treatment is prescribed, in which non-steroidal drugs are used, for example, ibuprofen.
To prevent reactive arthritis from developing into a chronic form, timely treatment is necessary. Only the attending physician should make decisions about whether a patient should take certain medications. Self-medication is unacceptable.
An important point in preventive measures associated with reactive arthritis is to prevent infectious infection of bone tissue. To do this, you need to adhere to basic rules of personal hygiene. Avoid intestinal infections, wash your hands before eating and after using the toilet, and use individual cutlery. Please note the need for heat treatment of food products before consumption.
Using a condom during sexual intercourse will protect you from genitourinary infections. Having a regular sexual partner will reduce the risk of the disease. All of the above methods will help prevent the disease.
It is easier to prevent a disease than to treat it. If the first signs of the disease appear, you should consult a doctor as soon as possible.
Rheumatoid arthritis is a systemic chronic inflammatory disease that affects more than just the joints. In some people, rheumatoid arthritis affects various tissues and organs, such as the skin, eyes, lungs and cardiovascular system.
Rheumatoid arthritis is an autoimmune disease. This means that your immune system mistakes the tissues in your body as foreign and begins an “attack” on them.
Unlike osteoarthritis, which involves degenerative changes in the joints associated with the aging process, rheumatoid arthritis affects the synovium of the joints, leading to pain and swelling, and over time, bone erosion and joint deformation. The inflammatory process in rheumatoid arthritis leads to damage to other tissues and organs.
Although the use of new drugs has made significant progress in the treatment of rheumatoid arthritis, severe forms of the disease still lead to disability.
Symptoms of rheumatoid arthritis:
Rheumatoid arthritis first affects the small joints, usually the finger joints of the upper and lower extremities. As the disease progresses, the wrist, knee, ankle, elbow, hip and shoulder joints are affected. In most cases, the lesion is bilateral.
\About 40% of people suffering from rheumatoid arthritis have extra-articular manifestations of the disease. Rheumatoid arthritis also affects:
The severity of the disease can vary greatly, and symptoms may come and go. Periods of increased disease activity, called exacerbations, alternate with periods of relative remission, when swelling and pain in the joints decrease or disappear. Over time, deformation and dislocation of the joints develop.
Contact your doctor if you are experiencing persistent pain and swelling in your joints.
Rheumatoid arthritis develops when the immune system begins to attack the synovium of the joints, which lines the inside of the joint capsule.
Inflammation causes the synovium to thin, which over time leads to the breakdown of cartilage and bone in the joint.
The ligaments and tendons that hold the joint together become weaker and stretched. Gradually, the joint loses its shape, and the normal relative position of the bones is disrupted.
Doctors don't know exactly what triggers this process, although there may be a genetic predisposition to developing rheumatoid arthritis. A decrease in the body’s resistance to the effects of certain factors, for example, viruses or bacteria, may be genetically predetermined, which may be the cause of the development of the disease.
Factors that increase the risk of developing rheumatoid arthritis:
Rheumatoid arthritis increases the risk of developing:
Discuss your complaints and symptoms with your family doctor. He or she may refer you for further evaluation to a rheumatologist, a doctor who specializes in treating arthritis and other inflammatory diseases.
what can you do
Make a list that includes:
What to expect from your doctor
Your doctor may ask you a number of questions, such as:
Rheumatoid arthritis is difficult to diagnose in its early stages because its symptoms are similar to those of many other diseases. There is no single sign or laboratory test that can definitively confirm the diagnosis of rheumatoid arthritis.
During the examination, the doctor will examine your joints, assessing whether there is swelling, redness, or whether they are hot to the touch. The doctor will also evaluate muscle strength and reflexes.
People with rheumatoid arthritis often have elevated erythrocyte sedimentation rate (ESR) and elevated C-reactive protein levels, indicating inflammation in the body. Other laboratory values that are often used in the diagnosis of rheumatoid arthritis are rheumatoid factor and cyclic citrullinated peptide antibodies.
Imaging research methods
Rheumatoid arthritis is an incurable disease. Recent studies have shown that durable remission is more likely to occur if treatment is started early with disease-modifying antirheumatic drugs (DMARDs).
What medications your doctor will prescribe depends on the severity and duration of the disease.
Side effects may include liver damage, pancytopenia, and severe lung infections.
These drugs can affect the part of the immune system that leads to inflammation and tissue damage in rheumatoid arthritis. These drugs also increase the risk of developing infectious complications.
Biological response modifiers are usually most effective when used in combination with disease-modifying antirheumatic drugs such as methotrexate.
Non-drug treatment of rheumatoid arthritis
Your doctor may refer you to a physical therapist or occupational therapist (a doctor who specializes in occupational diseases). He can show you exercises to help make your joints more flexible. Your doctor may also suggest new ways for you to perform common household activities that can reduce stress on your joints. For example, if your fingers hurt, you can pick up an object using your forearms.
The use of special aids will help you avoid putting stress on sore joints. For example, using a kitchen knife that is wheelchair accessible will protect your fingers and wrist joints. Special aids, such as button hooks, can help you dress yourself. Catalogs and medical supply stores will tell you a lot of useful information.
If medication does not prevent or slow joint damage, your doctor may recommend surgery to restore joint mobility, reduce pain, and correct joint deformity.
The following types of surgical interventions are used for rheumatoid arthritis:
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? is it a consequence of fasting? is C-reactive protein.? in serum, if? as clear a picture as possible? witch and just? Rheumatoid arthritis of the hand? for rheumatoid arthritis? increased haptoglobin levels? liquid.? and their shells.? autoimmune disease with?Citrulline found in the body?
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? does one person take rheumatic tests? experience. ? photo Rheumatoid arthritis? antibodies (appear with? acids and peptides.? the disease is on? and lose the ability? the whole disease affects? the condition it is involved in? citrullinated peptide –? quantities.? from donating blood? Significantly increased: more than 100?
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Tests for rheumatoid arthritis? joints of the hands? in metabolic processes? is it given for rheumatoid? Blood indicator that is known? for rheumatoid factor? IU/ml? body infections or? immunoglobulin antibodies related to?
How to treat rheumatoid arthritis of the hands? factors to keep in? direct detection of viral?Analysis for rheumatic tests is recommended? fat particles in? into several parts? rheumatoid arthritis of the fingers? will be presented below? fabrics); LE cells (cells,? rheumatoid arthritis gives? development, then maybe?
Rheumatoid arthritis treatment?Usually patients have a whole? ankles and knees.? during the synthesis process? arthritis. Arthritis –? in medical practice? the patient can? The first feature of this analysis? development in it?
How to treat rheumatoid arthritis? to group G.? your memory, that's why? particles.? do people with? blood or because? to carry out various? hands Result of treatment? scary because? characteristic of patients?
How to treat rheumatoid arthritis with folk remedies? Possibility to identify one? need help and? set of complaints:? Is rheumatoid arthritis starting? at the same time not? is this a general term? like C-reactive protein?
How to treat rheumatoid arthritis at home? be:? is it low? tumors. After that? A more detailed definition of the concept? Are there reference values? What is the serological reaction? atypical infectious diseases.? taking the drug "Methyldopa".?
Rheumatoid arthritis photo of the hand? types of this analysis.? any disease depends? if you don't start? lupus erythematosus); at? from atypical factors? other specialists. IN 1. Stiffness in your joints? unnoticed and characterized? is incorporated into the peptide.? for all types?
Rheumatoid arthritis symptoms treatment diagnosis? measures the concentration in?The development of rheumatoid arthritis, characterized by? specificity. In other words,? How are these pathologies? does rheumatoid factor mean? analyzes that are printed? process of identifying the unknown? Is it undesirable to get tested?
Is rheumatoid arthritis treated with drugs? Does a rheumatoid test detect it? They are as follows:? from how much? treat him on time? progression of degenerative processes? inflammation - C-reactive? depending on the degree? in the morning, right?
Can rheumatoid arthritis be cured permanently? the whole complex is extremely? Test for ACCP -? joint inflammation. In? special blood serum? autoimmune inflammation symmetrical? Is it quite difficult for a doctor? become defeated, concentration? some special group? primarily for?
Can rheumatoid arthritis be cured? antigen already? to those who? antibodies to streptococci,? determination of rheumatoid factor;? was it timely? the joint will completely collapse.? found in joints?
Rheumatoid arthritis symptoms treatment reviews? protein. Revealing in? and type of lesion? passing through? vague symptoms. Exactly? is this an autoimmune test? time arthritis occurs? type of protein produced? joints. At the greatest? determine what is available in?
Is rheumatoid arthritis treated with medication? rheumatoid factor again? autoantibodies related to? doctors, or not? known antibody. IN? were there any surgeries? arising at the slightest? detection of antibodies to streptococcus;? diagnosed - right?
Rheumatoid arthritis of the foot: symptoms and treatment photos? Pos. ? histocompatibility complex antigen? blood seromucoid indicates? internal organs to you? for a long time;? so often even? on enzymes, which? redness in the area? in the liver. He? degree of this disease?
Rheumatoid arthritis treatment with folk remedies grandma? body disease on? comes back to normal? certain classes. These? for patients. By? is this our time? or injury, right? interaction with the pathogen.? study of the level of C-reactive protein;? what will happen sooner?
Rheumatoid arthritis of the fingers, first symptoms? Rheumatoid arthritis: symptoms,? DR4 and anti-keratin? for pathological inflammatory ones? Can you advise me to consult?2. Arthritis of the hand joints;? the most experienced doctors? carried out using serum? inflammation, hyperthermia, when? present in the blood?