Rheumatoid arthritis is characterized by systemic erosion of bone tissue and chronic inflammatory processes of articular elements, with subsequent damage to organs.
The causes of the pathology may be the genetic characteristics of the body, weakness of the immune system or chronic infections. Most often, the disease affects women under 55 years of age.
The main problem of rheumatoid arthritis is the fact that the immune system mistakes the cells and tissues of its own body for “pests” and begins an active fight against them. This is how the primary signs of rheumatoid arthritis appear.
The insidiousness of this disease lies in the fact that in the early stages it is practically asymptomatic. Therefore, several months may pass from the onset of the disease to its detection.
But when the pathology is already in the progression stage, and serious symptoms begin to appear, it becomes extremely difficult to fight it. This is why it is very important to diagnose rheumatoid arthritis at the primary stage.
In order to suspect rheumatoid arthritis in time, you need to have an idea of its symptoms, namely:
The presence of one or two signs from this list does not indicate that rheumatoid arthritis is developing in the body. This is especially true for older people, for whom some symptoms are typical manifestations of age.
To make a final diagnosis, the doctor must have a clinical picture that excludes the possibility of other causes of the inflammatory process. To compile the clinical picture, in 1987 the American College of Rheumatology outlined diagnostic criteria for the disease.
The accuracy of these criteria varies in the range of 91-93%. Today this is the most correct scheme, however, it can sometimes give errors when it comes to the early stages of rheumatoid arthritis.
Doctors confidently diagnose rheumatoid arthritis only when the patient has at least four signs simultaneously.
In addition, other diseases in women that affect the joints cannot completely exclude rheumatoid arthritis. Only after this can treatment be prescribed.
It is impossible to make a diagnosis with one hundred percent accuracy even based on the results of laboratory diagnostics. However, only she has such concepts as the severity of ESR and anemia in a blood test, rheumatoid factor. Today, studies on ACCP are increasingly being carried out.
All these studies together give a real idea of rheumatoid arthritis and a fairly reliable prognosis of its further course. When conducting therapy, the main indicators of its success are considered to be assessment of the effectiveness and activity of DAS28.
It was already mentioned above that the main indicator of the disease is rheumatoid factor in the blood. However, the data from this study cannot be considered as the main indicators for making a diagnosis.
This is due to the fact that rheumatoid factor may indicate the presence of other pathologies. Moreover, it can be found in 5% of completely healthy people, and this figure increases with age.
Therefore, rheumatoid arthritis is confirmed in only one third of patients in whom rheumatoid factor was detected. Its presence is also used to make a prognosis of the disease using CRP and ACCP. If any titer has a high level, it means that the disease is progressing rapidly, and there are also extra-articular signs in the body.
Today, the most effective test for diagnosing rheumatoid arthritis is the analysis of antibodies to cyclic citrullinated peptide. His performance is as close as possible to one hundred percent.
Diagnosis is carried out by determining the number of ACCPs associated with the main signs of rheumatoid arthritis. These include:
The erythrocyte sedimentation rate is considered an indicator of the severity of the inflammatory process. ESR is determined by the rate at which red blood cells enter the measuring tube. In a healthy person, the ESR is low, but with inflammation it increases.
CRP is a test for C-reactive protein, which can also provide information about inflammation. But CRP is considered much more effective than ESR. Patients with arthritis have high CRP levels. A CRP test will help monitor how therapy is progressing and the body’s response to certain criteria.
If arthritis becomes severe, normocytic anemia develops. Therefore, the patient should get his blood tested as quickly as possible. Complications are typically characterized by a high platelet count in the blood and severe anemia.
During rheumatoid arthritis, white blood cell levels are normal. Only rarely can slight leukocytosis be observed, particularly with Felty's syndrome. There may be an increase in ESR and eosinophilia, which are also determined by a blood test.
When studying the results of a biochemical blood test, the doctor pays attention to the level of active proteins and ceruloplasmin. If their rate is increased, this indicates that the disease is in the progression stage.
This blood test provides auxiliary indicators, without which treatment is less effective.
All changes occurring in the synovium are recorded and are necessary for diagnosing rheumatoid arthritis. The fluid with this disease is most often cloudy, has a high concentration of protein, low viscosity and the same low glucose level.
Leukocytes in this case mainly consist of neutrophils, the total number of which ranges from 50 µl(-1) to 5,000 µl(-1). The leukocytes themselves are about 2,000 μl(-1), but their number is typical for different types of arthritis and is not particularly important when diagnosing rheumatoid arthritis in women.
In addition, immune complexes are formed in the synovial exudate, reducing the level of C3, C4 and the hemolytic activity of complement.
At the initial stages of arthritis, this diagnostic method is not effective. At this time, X-rays can only determine effusion in the joint cavity and swelling of soft tissues, but a physiological examination is sufficient to identify them.
To diagnose early signs of pathology, a hardware MRI examination or caste scintigraphy using 99mTc-distaphonate is necessary.
When rheumatoid arthritis is in the advanced stage, signs and symptoms can already be detected on x-rays. However, due to their nonspecificity, it is impossible to say with certainty that rheumatoid arthritis is the disease.
The purpose of an x-ray examination is to examine organs for the presence of bone erosion and determine the level of cartilaginous destruction. This serves as an indicator of the adequacy of treatment and the rationality of its continuation.
Radiography is carried out using several methods (Sharp, Steibrocker, Larsen). For each of them certain criteria are typical:
An X-ray is necessary to determine internal pathological changes, which makes it possible to prescribe adequate and effective treatment.
One of the common diseases leading to a person’s loss of ability to work and subsequent disability is rheumatoid arthritis.
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Supposed reasons:
Whatever factor causes this disease, it will certainly lead to disruption of the immune system..
As the disease progresses, it can persist throughout the day.
Rheumatoid arthritis is characterized by symmetry: if the elbow joint of the right hand is affected, then the joint of the left is likely to become inflamed.
With rheumatoid arthritis of the finger joints, there are several types of formation of a characteristic rheumatoid hand:
In these cases, the hand and fingers are not bent at physiological angles and are fixed in a certain position, reminiscent of this or that object. If left untreated, limb mobility may be completely lost.
Other small and larger joints also undergo changes, and the following occurs:
Rheumatoid nodules are pathological lumps localized under the skin, often subject to trauma in the elbow area and on the surface of the forearm. In rare cases, they form in the internal organs (trachea, lungs), in approximately 20–50% of patients.
Anemia may develop because, due to liver dysfunction, iron metabolism in the body slows down; the platelet count in the blood decreases.
Felty's syndrome: the number of neutrophils in the blood decreases, the size of the spleen increases.
Sjögren's syndrome: drying of the mucous membranes of the eyes and mouth.
In rheumatoid arthritis, symptoms of osteoporosis and amyloidosis are also diagnosed. Poorly healing ulcers in the shin area and inflammation of the arteries may occur.
For the medical history and treatment of a patient with rheumatoid arthritis, and doctors’ recommendations, see the video.
It is not difficult to completely restore JOINTS! The most important thing is to rub this into the sore spot 2-3 times a day.
To establish or confirm a diagnosis, a set of studies is prescribed, which includes:
With inflammation, the following is noted: an increase in the content of C-reactive protein, seromucoid, fibrinogen in the blood; positive rheumatic factor in 70–90% of cases; anemia; increase in ESR.
In the presence of pathology, it has a cloudy color, low viscosity, and an increased number of leukocytes and neutrophils.
The protein content and excess serum creatinine and urea levels confirm the diagnosis.
The photographs clearly show the blurring of the boundaries of the connecting surfaces of the articular tissues. In severe cases, fusion of the bones that articulate in the joint is noticeable.
The doctor selects an effective combination of medications for each specific case. The choice depends on the patient’s age, stage of the disease, concomitant and background pathologies, etc.
Typically includes the use of the following groups of drugs:
NSAIDs: meloxicam, nimesulide, celecoxib.
Their side effects are minimal, they have a strong anti-inflammatory and analgesic effect.
15 mg/day. (start of treatment); 7.5 mg/day. (maintenance therapy)
If the patient's body weight is less than 50 kg, it is recommended to prescribe the minimum dosage of the drug. You cannot combine non-steroidal drugs, as the risk of side effects increases while the level of effectiveness remains unchanged.
They are prescribed immediately after the diagnosis of rheumatoid arthritis. The main means of basic therapy are:
The effectiveness of basic drugs is assessed over a period of 3 months. If it is not high enough, they are replaced or combined with hormonal drugs in small doses, which suppresses the activity of rheumatoid arthritis.
During this procedure, the doctor constantly evaluates the activity of the disease and the manifestation of side effects, and, if necessary, adjusts the treatment.
In systemic therapy, the drug Wobenzym with a wide spectrum of action (anti-inflammatory, analgesic and immunomodulatory) is more often used. It is often combined with non-steroidal, basic and hormonal drugs.
Standard prescription: 7-10 tablets three times a day; for maintenance therapy: 3–5 tablets three times a day.
Glucocorticosteroids (hormonal drugs).
Hormones can be prescribed as an anti-inflammatory and local remedy if other drugs are ineffective. In the intensive phase of the inflammatory process, hormonal therapy is most effective. Without systemic manifestations, a course of treatment is prescribed.
In the presence of systemic manifestations, pulse therapy is performed, in which hormones in high doses are used together with slow-acting drugs, which significantly increases their effectiveness. In this case, the drug prednisolone is usually used, which has a positive effect on the joints.
Since the improvement does not last long, such treatment is required every 3-4 months.
External agents (ointments, gels and creams).
These include: ibuprofen, piroxicam, ketoprofen, amelotex, diclofenac. The preparations contain non-steroidal anti-inflammatory drugs and are used as applications on joints involved in the inflammatory process.
For rheumatoid arthritis, symmetrical (i.e., simultaneously on both sides) changes in the small joints of the hand are typical: metacarpophalangeal, interphalangeal, and also small joints of the feet (metatarsophalangeal).
Over time, changes and painful symptoms appear in other joints: wrist, tarsus, elbow, ankle, knee, shoulder, temporomandibular, hip, cervical spine.
In rare cases, the disease begins with inflammation of one large joint (knee, elbow, etc.).
Signs of joint damage:
Symptoms of damage to the articular surfaces increase gradually. At the initial stage, signs of inflammation may be inconsistent, even a short-term spontaneous remission is possible (when the articular syndrome goes away on its own - without treatment), but after a few weeks or months, the pain returns again and begins to intensify, and the dysfunction increases.
Pain, joint deformities, deviations and ankylosis cause significant impairment of the functions of the hands and limbs, reducing the patient’s quality of life and ability to self-care. Patients cannot perform the most common actions: fasten buttons and zippers on clothes, lift and hold a kettle, glass and spoon, open doors with a key.
Damage to the joints of the lower extremities (hip, knee, ankle) leads to limitation of movement - first, pain occurs during physical activity and walking, then it becomes difficult to simply stand and lean on the legs, and it becomes difficult for patients to walk without additional support on a cane and crutches.
Pain in the joints is a concern at the initial stage of the disease only during movements: in a typical localization with damage to the small joints of the hand, attempts to bend and straighten the fingers and associated movements (holding a pen when writing, fastening buttons and other finger work) become painful.
As the disease progresses, the pain becomes chronic and bothers patients even at rest, including at night.
Morning stiffness is a limitation, the inability to make full movements in the morning, after waking up. Morning stiffness is an important diagnostic sign of rheumatoid arthritis if it persists for an hour or more.
Symptoms such as swelling and redness around the joint occur simultaneously or some time after the pain occurs. At first, there is only a slight transient swelling and slight redness, later the swelling becomes permanent, dense, and the skin over the joints is red, thinned, and shiny.
Dysfunction in the form of limited or inability to work joints develops first as a defensive reaction due to pain (the patient consciously or unconsciously limits painful movements and in this way seems to spare the joint). In the later stages of rheumatoid arthritis, limitation of movements is due to the formation of joint deviations and deformities.
The inability to fully bend or straighten a limb (finger) at a joint is called contracture.
Muscle atrophy - thinning and weakening of muscles - occurs due to complete or partial immobility of the limb (fingers) and the transition of the inflammatory process to nearby tendons and muscles.
Deviation - deviation of bones that articulate in a joint - develops as a result of long-term and irreversible muscle contractures and the formation of subluxations. Characteristic is ulnar deviation - the so-called “walrus fin” - deviation of the fingers outward, towards the ulna.
Deformity is a pronounced, disfiguring change in the shape of a joint, first due to swelling, and then due to subluxations, the spread of the pathological process to the articular cartilage and segments of articulating bones. In the later stages, joint deformities typical of rheumatoid arthritis occur:
Ankylosis is complete immobility in the joint due to the destruction of cartilage and the formation of fibrous and bony adhesions between the articulating surfaces of the bones.
Symptoms of rheumatoid arthritis are not limited to joint damage alone. After the onset of the disease, general symptoms appear:
Over time, other organs and tissues become involved in the immunoinflammatory process:
Anemia is a common companion to rheumatoid arthritis. It is characterized by a decrease in red blood counts (the number of red blood cells, hemoglobin, color index, etc.) and sideropenic syndrome (external signs of iron deficiency) in the form of striations, layering and brittleness of nails, hair loss, the appearance of “jams” in the corners of the mouth, peeling of the skin.
The symptoms of rheumatoid arthritis are very varied. In the initial stages, the disease can proceed rather sluggishly, without causing much suffering to the patients. However, it should be remembered that joint damage progresses very quickly, and over time the pathological process can spread to other organs. Therefore, it is extremely important that when the first symptoms of the disease occur, immediately contact a doctor - a therapist, rheumatologist or arthrologist for examination and prescribing adequate treatment.
Author: Svetlana Agrineeva
The cause of rheumatoid arthritis is unknown. The probable cause may be various viruses, bacteria, trauma, allergies, heredity and other factors.
The frequency of occurrence is 1% in the general population. The predominant age is 22–55 years. The predominant gender is female (3:1).
Symmetry of joint damage is an important feature of rheumatoid arthritis (for example, the right and left elbow joints or the right and left knee joints are affected)
Damage to periarticular tissues
Tenosynovitis in the area of the wrist and hand (inflammation of the tendon, characterized by swelling, pain and a distinct creaking sound during movement).
Bursitis, especially in the elbow joint.
Damage to the ligamentous apparatus with the development of increased mobility and deformities.
Muscle damage: muscle atrophy, often drug-induced (steroid, as well as while taking penicillamine or aminoquinoline derivatives).
Rheumatoid nodules are dense subcutaneous formations, in typical cases localized in areas that are often subject to trauma (for example, in the area of the olecranon, on the extensor surface of the forearm). Very rarely found in internal organs (for example, in the lungs). Occurs in 20–50% of patients.
Anemia due to a slowdown in iron metabolism in the body caused by impaired liver function; decreased platelet count
Felty's syndrome, including a decrease in neutrophils in the blood, an enlarged spleen,
Sjögren's syndrome – dryness of the mucous membrane of the eyes and mouth.
Also, with rheumatoid arthritis, signs of osteoporosis (this is a loss of bone tissue) and amyloidosis may appear.
Ulcers on the skin of the legs and inflammation of the arteries are common.
In general and biochemical blood tests:
The joint fluid is cloudy, with low viscosity, and the number of leukocytes and neutrophils is increased.
Rheumatoid factor (antibodies to immunoglobulin class M) is positive in 70–90% of cases.
Urinalysis: protein in urine.
An increase in creatinine, serum urea (assessment of renal function, a necessary stage in the selection and control of treatment).
American Rheumatological Association Diagnosis Criteria for Rheumatoid Arthritis (1987). Presence of at least 4 of the following:
Rheumatoid arthritis is a chronic disease characterized by symmetrical inflammation of the peripheral joints of the hands, wrists, elbows, shoulders, hips, knees and feet. Rheumatoid arthritis causes joint damage due to persistent inflammation of the synovium, the membrane lining the joint cavity. Next, the disease affects the cartilaginous bone, bone erosion and joint deformation occur. This disease mainly affects the joints, but in rare cases the disease can affect other systems (lungs, heart and nervous system).
The reasons for the development of rheumatoid arthritis are still unknown, but a separate genetic factor is identified. It has been established that this is an autoimmune disease: the immune system produces antibodies directed against its own synovial tissue.
About one to two percent of the population suffers from this disease. Rheumatoid arthritis occurs two to three times more often in women than in men. With age, the incidence of the disease increases, and gender differences level out after 50 years. Rheumatoid arthritis is common throughout the world, regardless of race.
It can begin at any age and often affects young people. In 80% of people, the disease develops between the ages of 35 and 50 and peaks in the fourth and fifth decades of life.
There is a strong genetic predisposition to developing rheumatoid arthritis: severe forms of the disease are four times more common in immediate family members of those with arthritis.
Rheumatoid arthritis is accompanied by chronic polyarthritis (inflammation of several joints at once). In two out of three patients, the disease begins insidiously, with fatigue, muscle weakness and joint symptoms until inflammation of the synovium becomes obvious. This initial stage may last for several weeks or months.
The characteristic symptoms tend to appear gradually, with symmetrical inflammation of several joints, particularly the joints of the hands, wrists, knees and feet.
About ten percent of people experience atypical symptoms: sudden onset of polyarthritis, sometimes with fever and systemic illness, or involvement of only one joint, such as the knee.
Main symptoms: stiffness, pain on palpation of all inflamed joints. General joint stiffness is a common symptom. It usually gets worse after inactivity. The stiffness is usually felt in the morning and lasts more than an hour. The duration of morning stiffness can indicate the degree of inflammation, since as a result of treatment the stiffness begins to subside.
Inflammation of the synovial membrane leads to swelling, pain, and limitation of movement. The skin over the joints (especially large joints) becomes warm.
Joint swelling occurs due to the accumulation of fluid in the synovial cavity, thickening of the synovium and joint capsule. The inflamed joint is in a bent position, in which pain is minimized. As a consequence of the damage, permanent deformation of the joint develops.
Rheumatoid arthritis can also manifest itself in other symptoms that are not directly related to the joints.
In order to give a correct assessment of a health problem, it is necessary to conduct a clinical study.
There are no tests that accurately determine the presence of rheumatoid arthritis. Less than 85% of patients with rheumatoid arthritis were rheumatoid factor positive. Many patients test negative (seronegative rheumatoid arthritis). The mere presence of rheumatoid factor in the blood is not a reason for making a diagnosis. However, a high level of this factor in the blood may indicate the presence of a more severe and progressive disease, which is not characterized by the manifestation of joint symptoms. Moreover, the test can be positive in older people, as well as in other conditions. If rheumatoid factor has been detected, there is no point in repeating the test. The most advanced test, the titer of antibodies to cyclic citrulline-containing peptide (ACCP, anti-CCP), has proven to be more specific and suitable for diagnosing rheumatoid arthritis.
People with active rheumatoid arthritis suffer from anemia. The erythrocyte sedimentation rate (ESR) and C-reactive protein levels increase in many patients. These indicators, which exceed the norm, are “markers of inflammation” and the subject of observation, as they identify the progress or regression of the disease.
At an early stage of the disease, X-rays do not always help determine the diagnosis. X-rays reveal swelling of the soft tissue near the joints and the presence of fluid in the joint space. At the same time, the early appearance of marginal bone erosion indicates the active development of rheumatoid arthritis and requires urgent invasive treatment. As the disease progresses, the abnormalities become more noticeable, with narrowing of the joint space and bone destruction observed. X-ray radiation is carried out in order to monitor the progression of the disease, as it provides reliable information about the patient’s health status after the treatment methods used.
At the moment, no one knows how to prevent the development of arthritis. It is not recommended to do a routine blood test for all family members. Smoking has been found to be a risk factor. An unfavorable outcome of the disease is guaranteed if a person suffering from rheumatoid arthritis constantly smokes.
It is important to understand that rheumatoid arthritis is treatable and requires prompt surgical intervention. This is a medical problem, so when choosing a doctor, preference should be given to a rheumatologist. Homeopathic medicines containing Omega-3 and Omega-6 fatty acids may help relieve pain and reduce inflammation, however, there is no scientific evidence that such treatments have any effect on the outcome of the disease.
The treatment strategy for rheumatoid arthritis is based on the use of disease-modifying antirheumatic drugs. In order to achieve remission of the disease, it is necessary to begin this treatment as soon as possible. During remission, the swelling and pain on palpation of the joints disappear or laboratory indicators of inflammation are normalized as a result of the patient’s treatment.
Exercise and physical therapy may help. Physical exercise is aimed at developing muscle strength and joint mobility without exacerbating joint inflammation. Before performing physical exercises, the inflamed joint is immobilized using a splint, allowing passive stretching in order to maintain the range of motion of the joints. Once the swelling has stopped, activity and exercise are encouraged. The slogan is: “ If there is a tumor, rest, if not, move!” "
(a) Relief of symptoms and reduction of inflammation
Conventional pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed to relieve pain and stiffness. Selective COX-2 inhibitors have minimal gastrointestinal side effects. These include celecoxib. The safety profile of selective COX-2 inhibitors is more favorable than that of non-steroidal anti-inflammatory drugs. But people suffering from cardiovascular diseases should be careful with COX-2.
(b) Non-steroidal anti-inflammatory drugs
The use of disease-modifying (disease-modifying) antirheumatic drugs (DMAs) is necessary in the first stage of intensive care. These medications reduce damage to the joint. The most popular representative of this group of medications is methotrexate. This medicine was originally developed for chemotherapy. However, it has proven to be very effective in treating rheumatoid arthritis and now forms the basis of most treatment programs. Chloroquine, an antimalarial drug, and sulfasalazine are older drugs often used in combination with methotrexate. Leflunomide is a more expensive but very effective disease-modifying drug, often prescribed when methotrexate has not resulted in remission of the disease.
Newer biological therapies are now available, including medications that block the development of inflammatory cells. New drugs inactivate tumor necrosis factor. Their use has shown excellent results in controlling the progression of the disease and preventing joint damage. But the price of these drugs is very high.
Hydrocortisone in low doses is useful in treating symptoms of rheumatoid arthritis while waiting for the results of treatment with disease-modifying drugs. It acts quickly and counters all aspects of the disease. However, side effects are dose dependent, so long-term use of hydrocortisone is not advisable. The continued need to use oral hydrocortisone indicates that the disease is not completely under control, so more intensive therapy with disease-modifying drugs is required.
Hydrocortisone injections intramuscularly or directly into a joint in reasonable doses help control flare-ups of rheumatoid arthritis. Large doses of hydrocortisone are contraindicated for use in potentially life-threatening situations when the disease is systematic and any organ is affected. Medicines in this case can be vital.
Surgery can improve the health situation in the relatively early stages of the disease if one large joint (knee or wrist) is persistently inflamed. This surgery (synovectomy) removes the synovial lining of the joint, resulting in long-term relief of symptoms. Joint replacement surgery is performed for patients with more severe joint damage. The most successful operations are on the hips and knees. Surgical intervention has the following goals: to relieve pain, correct deformities and improve the functional state of joints. Rheumatoid arthritis is primarily a medical problem. Therefore, surgery is reserved for those who are under the supervision of an experienced rheumatologist or doctor.
The course of rheumatoid arthritis varies and is difficult to predict. If treated appropriately during the first three to six months of illness, the overall outlook is encouraging. Delay in initial treatment is a major factor influencing the final prognosis of the disease. In most people, the disease develops steadily, but with fluctuations, with varying degrees of joint deformation.
Over the past ten years, arthritis outcomes have improved as a result of treatment with disease-modifying drugs. In a small number of patients, the inflammatory process is short-lived and does not cause significant deformation. Remission of the disease can occur in the first year, but in order to achieve it, drug treatment is required. The greatest progression of the disease is observed during the first two to six years, after which it slows down.
Elderly people with signs of severe radiation sickness, rheumatoid nodules and high levels of rheumatoid factor are most susceptible to developing severe forms of rheumatoid arthritis.
The average life expectancy of people with rheumatoid factor is slightly shorter. Optimal medical treatment has been shown to not only improve the patient's quality of life, but may also not affect life expectancy. The main causes of increased mortality are infection, gastrointestinal bleeding, malignancy and cardiovascular disease.
The goal of using disease-modifying drugs is to achieve remission. It is important to understand that these medications are long-acting. Suspension of their use will inevitably lead to an outbreak of the disease, usually within three weeks of cessation.
Regaining control of the disease after this may be difficult. Drug treatment must be carried out under appropriate supervision, as drugs may cause side effects. If you are taking disease-modifying antirheumatic drugs, you should have regular blood tests.
You cannot do without consulting a doctor if:
Remember that optimal treatment and its adherence can “control” the disease. This requires early intervention, adherence to treatment and a positive mental attitude.
Rheumatoid arthritis is a connective tissue disease that develops in individuals with a genetic predisposition after exposure to certain provoking factors. The disease most often occurs in women over 40 years of age and is characterized by the development of irreversible degenerative and inflammatory processes in small joints, as a result of which their normal functioning is disrupted.
Rheumatoid arthritis can be seropositive (occurs in most cases) or seronegative. In the first case, rheumatoid factor is present in the patient’s blood, and the disease develops gradually.
When seronegative RA is detected, rheumatoid factor is absent, the clinical picture of the disease develops quickly, beginning with inflammation of the joints of the wrist or knee joint.
According to ICD 10, rheumatoid arthritis is designated M05 (seropositive), M06 (seronegative) and M08 (juvenile) - a detailed table of codes is at the end of the article.
Rheumatoid arthritis is often confused with arthrosis or regular arthritis. These are completely different diseases, although in both cases there is damage to the joints, the difference between rheumatoid arthritis and arthritis can be seen in the table:
The development of rheumatoid arthritis can be caused by numerous factors, the most common of which are:
Most often, rheumatoid arthritis develops in the cold season; the provoking factor can be hypothermia, viral or infectious diseases, surgery, or food allergies.
At the initial stage of development, the disease may not manifest itself in a pronounced clinical manner; a patient with rheumatoid arthritis is concerned about general symptoms:
As the pathological process progresses, pain in the joint area is added, which is aching, periodic, and constant.
After the slightest physical exertion or during treatment with anti-inflammatory drugs, the pain syndrome intensifies, and symmetrical damage to small joints appears.
The inflammatory process in rheumatoid arthritis of the joints is accompanied by fever, lethargy of the patient, general weakness, and muscle pain.
A characteristic sign of rheumatoid arthritis in the hands is the appearance of stiffness in the morning, mainly after sleep. The patient cannot perform the usual actions with his fingers; they seem to not obey.
Attempts to move the fingers are accompanied by increased pain, which goes away after about 40 minutes. Morning stiffness is due to the fact that during the night pathological fluid accumulates in the area of joints affected by degenerative and inflammatory processes, which prevents full movements.
As the pathological process progresses, the patient develops visible deformations of the limbs - “walrus flippers”, spindle-shaped fingers and a swan neck. The first signs of rheumatoid arthritis include other joint lesions:
In addition to joint lesions, signs of rheumatoid arthritis are other manifestations:
In most cases, rheumatoid arthritis develops gradually, the first symptoms of the disease are:
A little later, to the general signs of intoxication of the body, symptoms of joint damage are added:
The first symptoms of rheumatoid arthritis of the fingers are similar to the general symptoms, but may be more pronounced:
It is important not to ignore the first symptoms of finger arthritis, but to immediately consult a rheumatologist for diagnosis and prescription of medications. Advanced cases of the disease are much more difficult to treat and restore all joint functions.
Extra-articular lesions of the body develop against the background of rapid progression of rheumatoid arthritis, as a result of which blood circulation and nutrition of the tissues adjacent to the affected joint are disrupted.
If the above-described clinical manifestations of rheumatoid arthritis appear, the patient should contact a local physician as soon as possible, who will prescribe a detailed examination to confirm the diagnosis.
Diagnosis of RA includes:
Timely diagnosis and treatment of rheumatoid arthritis can prevent numerous complications and significantly improve the patient’s quality of life.
Since the exact causes of the development of rheumatoid arthritis have not been identified, treatment of the disease comes down to symptomatic therapy and preventing further progression of joint deformity.
Drugs for rheumatoid arthritis are selected by the attending physician, depending on the clinical picture of the disease:
Outside the period of exacerbations of the disease, treatment of rheumatoid arthritis consists of exercise therapy, physiotherapeutic procedures, and surgery to correct joint deformities and restore its mobility.
In the absence of timely diagnosis and treatment of rheumatoid arthritis, the patient gradually develops complications:
In order to prevent the development of rheumatoid arthritis, patients at risk should follow simple recommendations from doctors: