A disease of the joints that results in deformation and destruction within them is called rheumatoid arthrosis. Degenerative processes affect cartilage, bone and even soft tissue. They are irreversible and lead to severe deformations. In case of severe tissue destruction, osteoarthritis develops, which affects not only the joint, but also the adjacent bones.
Rheumatoid arthrosis is an autoimmune disease, and it affects several joints at once. It is based on circulatory disorders, changes in the functioning of blood vessels and metabolic failures. Most often it develops against the background of rheumatoid arthritis. In this case, inflammation, which occurs due to the fact that the joint tissues are perceived by protective blood cells as a foreign body, leads to their destruction.
Previously, it was believed that this disease occurs only in older people. But recently, rheumatoid arthrosis occurs even in children. For what reasons does this happen?
Unlike ordinary arthrosis, its rheumatoid form affects several joints at once. The disease can start from the hip and spread downwards or from the ankle up. Over time, degenerative processes intensify.
The symptoms of rheumatoid arthrosis are quite specific. Using them, you can determine if you have the disease and consult a doctor. What symptoms should alert a person?
If a person notices such symptoms, he needs to see a doctor as soon as possible. Although arthrosis is an incurable disease, the destruction can be stopped with the help of medications and auxiliary means.
Joint pain is the main symptom of arthrosis
To make a correct diagnosis, the doctor prescribes several examination methods:
Treatment of the disease should be aimed at getting rid of its causes. Therefore it must be comprehensive. In addition to relieving the inflammatory process, eliminating pain and restoring joint mobility, it is important to carry out general strengthening therapy, treat chronic diseases and improve vascular function. What rules should the patient follow to stop the degenerative process and alleviate his condition?
Medications help relieve pain and slow down joint destruction
Most drugs prescribed for rheumatoid arthrosis are supposed to relieve pain and improve the nutrition of joint tissues. The following groups of drugs are most often prescribed:
In addition to the use of drug therapy prescribed by a doctor, other methods may be used. Treatment of arthrosis is aimed primarily at increasing periods of remission and preventing further tissue destruction. The following methods are very effective for this:
Physiotherapeutic methods help restore joint mobility
When used correctly, such methods can alleviate the patient's condition. But folk remedies should only be an auxiliary method, an addition to the main treatment. The following methods are considered the most effective:
If you lead an active lifestyle, avoid hypothermia and eat right, you can keep your joints healthy until old age. It is important to be attentive to your health and consult a doctor with any injuries, and promptly treat infectious and chronic diseases. You should try to avoid unnecessary stress and weight gain. Recently, it has been proven that rheumatoid arthrosis can be provoked by stress and long-term depression. Yoga, breathing exercises, walks in the fresh air, or taking sedatives will help you avoid nervous tension.
Treatment of rheumatoid arthrosis is complex and lengthy, so it is better to prevent joint destruction. And when the first symptoms appear, it is important to consult a doctor in time. Only by performing all therapeutic measures is it possible to stop the destruction of the joint and restore freedom of movement.
Diseases of the musculoskeletal system always bring a lot of discomfort and pain. They are provoked by various reasons. But there are pathologies of a systemic nature that cannot be completely cured, and the patient should be given maximum assistance. Such a disease is rheumatoid arthritis.
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The pathology is quite common: in women the disease is much more common than in men. Age does not matter for rheumatoid arthritis, as it has become much younger in recent years.
The disease is progressive in nature and can lead to complete disability of a person.
Rheumatoid arthritis is a systemic disease whose etiology is still unknown. It is characterized by damage mainly to the connective tissue of the joint; erosive changes occur in the joints.
Rheumatoid disease is progressive and chronic. Over time, complete deformation and destruction of the joints occurs. The joints lose mobility, and the person becomes disabled.
The disease can affect not only the skeleton, but also internal organs: heart, kidneys, blood vessels, lungs, muscles. The pathology begins with an inflammatory process, which is localized in the synovial membrane of the joint. Over time, it spreads to cartilage and bones. The speed of development of the disease varies.
The body’s autoimmune reaction also leads to aggravation of the patient’s condition: the defense system begins to destroy its cells. Most often, it is the small joints of the legs and arms that are affected. However, the inflammatory process can affect other areas of the body.
Any infection can cause systemic pathology, so you need to take responsibility for your own health.
Most often, the first signs are ignored, so the disease can progress further.
Joint symptoms of rheumatoid arthritis:
Other signs of the disease:
Extra-articular symptoms of arthritis:
Rheumatoid arthritis can affect the gastrointestinal tract, nervous system, respiratory system, kidneys, heart and blood vessels. Therefore, the disease can cause additional pathologies in these organs: colitis, neuropathy, polyneuritis, pleurisy, pneumonitis, bronchiolitis, amyloidosis, arteritis, myocarditis, pericarditis.
The early phase of the disease is characterized by the manifestation of exudate; there is effusion in the joints. When palpating the affected joints, the patient feels sharp pain. Limb movement is significantly limited. The skin over the joint is hot to the touch and red in color.
Not only small but also large joints (hip) can be damaged. Spinal lesions are rare: the spinal column is affected only at the last stage of development of rheumatoid arthritis, mainly the cervical region.
If the inflammatory process spreads to the temporomandibular joint, the patient cannot open his mouth normally and has difficulty eating.
Classification of the disease is very important for prescribing treatment. There is some dependence on the patient’s age: the peak development of the pathology can be reached only at 50 years old, although it can begin to develop at 20.
There are types of disease:
As for the stages of development of rheumatoid arthritis, there are only 4 of them:
Diagnosis is difficult, since most symptoms are not specific. The diagnosis must be differentiated.
It is necessary to pay attention to the fact that such symptoms will appear in the patient. For example, a doctor can already make a diagnosis based on the presence of the following criteria:
Diagnostic tests are prescribed:
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Signs of rheumatoid arthritis may include the following symptoms: skin diseases (vasculitis, dermatitis), lung pathologies, eye diseases, disorders of the circulatory system, diseases of the cardiovascular system (heart attack, stroke).
Diagnosis of rheumatoid arthritis can also be complicated by the fact that the symptoms of the disease are similar to other disorders in the body: gout, fibromyalgia, osteoarthritis, arthrosis, systemic lupus, infectious inflammation of the joint.
Only differentiated diagnostics will accurately determine the presence of the disease and prescribe the necessary treatment.
Juvenile rheumatoid arthritis is a fairly severe form of chronic inflammatory process that affects children under 16 years of age. The etiology of the disease is unknown, and its pathogenesis is very complex. Very often this form of arthritis ends in disability.
This disease of the supporting apparatus in children is quite rare, but compared to other skeletal pathologies it ranks first. The symptoms of the pathology are in many ways similar to the clinical picture in adults, but its manifestations are more pronounced.
For example, the temperature rises to 38-39 degrees. A polymorphic allergic rash may appear on the skin, the spleen, liver, and regional lymph nodes may enlarge, and anemia may occur.
If the disease was detected in a child under two years of age, he may stop walking altogether. This form of pathology can cause eye damage, which is most often found in girls of preschool age. The quality of treatment depends on how quickly the diagnosis was made and how correctly the treatment was carried out. Therapy in this case will not be easy.
Rheumatoid arthritis cannot be completely cured. However, this does not mean that there is no need to fight it.
Key treatments:
Rheumatoid arthritis must be treated, taking into account not only the nature of the disease, but also the severity of its symptoms. The patient may not need to take any serious medications. At the initial stage of pathology development, treatment is gentle. If it is ineffective, radical types of therapy are used.
The affected joints need to be given rest, as heavy, prolonged stress only increases inflammation. To completely immobilize the joint, orthopedic splints are used.
Drug treatment with the prescription of several groups of drugs:
Drug therapy is effective only in combination with physiotherapeutic methods and physical therapy. Exercises in the pool are useful when there is active movement of the joints, but they do not experience stress.
In some cases, the patient is indicated for surgery. Radical intervention is a last resort. Medicine at this stage of development makes it possible to completely or partially replace a diseased joint with an artificial one.
Thanks to the operation, it is possible to restore normal mobility of the affected joints and avoid loss of ability to work. In some cases, surgery is aimed at fusion of certain joints, for example, when the foot is affected. In this case, specialists can achieve a reduction in pain attacks.
During treatment, it is important to use special orthopedic devices: boots, means for gripping objects, which will help improve a person’s quality of life.
Treatment of rheumatoid arthritis is quite effective with the drug Methotrexate. It cannot be purchased freely at pharmacies, as it is sold with a doctor’s prescription. The main effect of the medicine is aimed at eliminating compounds that cause the destruction of connective tissue in the joints. The drug is able to prevent erosion of joints and relieve inflammation. Therapy lasts quite a long time. The medicine is used in courses.
Treatment of rheumatoid arthritis is possible not only with medications. Traditional recipes will also be useful, but they are used only after consultation with a doctor. They cannot replace primary therapy.
Treatment of rheumatoid arthritis with folk remedies and nutrition is an integral part of complex therapy. However, this is not the preferred method.
Rheumatoid arthritis can cause the following complications:
The appearance of the first symptoms of rheumatoid arthritis should alert you, because the lack of treatment leads to the fact that it becomes difficult for the patient not just to live, but to exist.
No specific preventive measures have yet been established. However, some recommendations will make it possible to significantly reduce the frequency of attacks of exacerbation of rheumatoid arthritis.
Rheumatoid arthritis is a complex disease that shortens life expectancy by 3-12 years. At the same time, patients have a significantly increased risk of heart disease.
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Arthrosis is a disease of the joints, which is based on the process of degenerative changes in cartilage that develop as a result of deterioration in its nutrition (trophism) or disruption of its configuration, for example, after an injury.
Arthrosis-arthritis is a disease characterized not only by degenerative processes occurring in the joint, but also by its inflammation.
Deforming osteoarthritis is arthrosis, one of the manifestations of which is the proliferation of bone tissue, leading to deformation of the ends of the bones that form the joint.
Periarthrosis is a dystrophic process in which degenerative changes are observed not only in the joint itself, but also in the tissues adjacent to it (for example, tendons, ligaments).
Hemarthrosis is hemorrhage into the joint cavity.
The leading cause of the development of arthrosis is a metabolic disorder occurring in cartilage tissue. As a result, the cartilage loses its elasticity and begins to gradually deteriorate.
The causes of metabolic disorders and the development of degenerative changes in joints are varied. It can be:
In women, arthrosis of the ankle joint and foot can occur due to prolonged wearing of narrow and uncomfortable shoes, including high heels. Changes in the joints of the hands are observed mainly in representatives of those professions where a significant part of the load falls on the hands (while arthrosis is much more common in women).
In addition, arthrosis of the knee, hip or ankle joint is provoked by various injuries (post-traumatic arthrosis).
Arthrosis is classified according to the degree of joint damage:
Sometimes experts also distinguish the fourth degree of arthrosis, characterized by intense pain and serious deformations of this area.
Most often, this term refers to degenerative-destructive changes in the joint that developed as a result of another disease - rheumatoid arthritis. Rheumatoid arthritis itself changes the configuration of the articular surfaces, which entails a violation of their congruence and aggravation of degenerative processes in the articular and periarticular tissues.
This is the appearance of degenerative-dystrophic changes in the cervical spine. The main symptoms of osteoarthritis of this localization:
X-ray examination may reveal subluxation of the cervical joints.
In addition, arthrosis is distinguished:
Before deciding how to treat it at home, you should visit a doctor and determine the exact cause of this disease. To do this, the doctor usually examines the patient and prescribes a series of additional laboratory and instrumental tests, including various biochemical blood tests (for example, for acute phase reactions, the presence of rheumatoid factor, etc.), as well as radiography, ultrasound, MRI or CT of the joints . If necessary, the examination is supplemented by diagnostic arthroscopy.
Next, the doctor makes an accurate diagnosis and prescribes appropriate treatment for the joint.
Ointments, gels, creams that have anti-inflammatory and distracting effects are applied locally to the joint area 2-3 times a day, compresses with dimexide are applied, and rubbing is used.
To relieve pain and inflammation, ultraviolet irradiation in erythemal doses, laser therapy, UHF, microwave, electro- and phonophoresis are widely used. In addition to physiotherapeutic procedures, regular therapeutic exercises for joints and sanatorium and resort treatment are useful for arthrosis.
Usually this is a partial or complete replacement of the joint or its plastic surgery. It can be performed in the traditional way, as well as using endoscopic and minimally invasive surgery, including arthroscopy. Surgeries are indicated in cases where conservative treatment does not have the desired effect, as well as in cases of severe deformation of the joint and loss of mobility.
First of all, prevention of arthrosis includes diet, exercise and avoidance of hypothermia.
Nutrition for arthrosis does not require any serious restrictions. In general, this is a balanced diet, including all the main food groups, drinking enough liquid, as well as fresh vegetables and fruits. Many experts recommend periodically including jellied meat, rich broths and other similar dishes in the menu, unless they are contraindicated by a doctor.
Spicy and burning food in itself does not have a significant effect on arthrosis, but it should be remembered that many people suffering from this disease are forced to use painkillers and anti-inflammatory drugs, most of which negatively affect the gastric mucosa. It is also advisable to limit foods that are rich in cholesterol and lead to increased blood viscosity so that the blood supply to the joint is not impaired. For these reasons, it is advisable to exclude such dishes from your daily menu if you have arthrosis.
Exercise and physical activity improve blood circulation and blood supply to joint tissues, and also strengthens muscles. The most useful exercises for arthrosis are swimming, walking, and skiing. For coxarthrosis, gonarthrosis in combination with excess weight, cycling or exercise on an exercise bike has worked well.
Joints “love” when a person dresses according to the weather, evenly protecting all parts of his body from the cold. Any local hypothermia causes a weakening of the body's defenses, which can result in subsequent inflammation of the joints and the development of degenerative processes in them.
Rheumatoid arthritis is a systemic disease of unknown etiology with widespread damage to connective tissue, mainly in the joints, with erosive changes in them, with a chronic, often relapsing and progressive course. The trigger can be an infection, a cold, or an injury.
The pathological process leads to complete destruction of articular tissues, gross deformations and the development of ankylosis, which leads to loss of joint function and disability.
In severe cases, internal organs (heart, kidneys, lungs, blood vessels, muscles, etc.) can also be affected, which significantly worsens the prognosis for rheumatoid arthritis. We will discuss the symptoms, diagnosis and treatment methods in detail in this article.
The prevalence of rheumatoid arthritis among the adult population of various climatic and geographical zones averages 0.6 - 1.3%. The annual incidence over the past decade has remained at 0.02%.
An increase in rheumatoid arthritis with age has been noted; women are more often affected than men. Among people under 35 years of age, the prevalence of the disease is 0.38%, in people aged 55 years and older - 1.4%. A high incidence of the disease was detected in first-degree relatives of patients (3.5%), especially in females (5.1%).
Why does rheumatoid arthritis occur and what is it? Rheumatoid arthritis is an autoimmune disease, that is, a disease that occurs when the normal functioning of the immune system is disrupted. As with most autoimmune pathologies, the exact cause of the disease has not been identified.
It is believed that the provoking factors for the occurrence of the disease are:
Under the influence of these factors, cells of the immune system begin to attack the cells of the joint lining, which causes inflammation in them. This process causes the joints to become swollen, warm, and painful to the touch. Cells of the immune system also cause damage to blood vessels, which explains the so-called extra-articular symptoms of rheumatoid arthritis.
Juvenile rheumatoid arthritis (Still's disease) is an inflammatory disease of the joints, it is characterized by a progressive course with a fairly rapid involvement of internal organs in the process. This disease occurs in 5-15 people per 100,000 children.
The disease occurs in children under 16 years of age and can last for many years. The appearance of the disease can be the result of various influences - viral and bacterial influences, cooling, medications, increased sensitivity to certain environmental factors and many others.
Rheumatoid arthritis can begin acutely and subacutely, with the latter type of onset observed in most cases.
The first signs of RA:
As a rule, such manifestations of the disease remain unattended, and then articular syndrome and extra-articular manifestations of the disease develop.
In the case of rheumatoid arthritis, when studying the patient’s complaints, special attention is paid to the following symptoms:
A patient with rheumatoid arthritis may also have other symptoms:
Upon palpation you can detect: an increase in skin temperature over the surface of the joints; soreness of the affected joints; “lateral compression” symptom; muscle atrophy and skin thickening; subcutaneous formations in the joint area, most often the elbow, so-called rheumatoid nodules; Patellar balloting symptom to determine the presence of fluid in the knee joint.
Depending on clinical and laboratory data, there are 3 degrees of exacerbation of RA:
In RA, peripheral joints are primarily affected, but we must not forget that this is a systemic disease, and any organs and tissues where connective tissue is present can be involved in the pathological process.
The development of extra-articular (systemic) manifestations is more typical for the seropositive form of rheumatoid arthritis with a severe long-term course.
The presence of rheumatoid vasculitis, which occurs in 10-20% of cases.
The most severe course of rheumatoid arthritis is characterized by forms that occur with lymphadenopathy, damage to the gastrointestinal tract (enetritis, colitis, amyloidosis of the rectal mucosa), nervous system (neuropathy, polyneuritis, functional autonomic disorders), involvement of the respiratory system (pleurisy, diffuse fibrosis, pneumonitis, fibrosing alveolitis , bronchiolitis), kidneys (glomerulonephritis, amyloidosis), eyes.
On the part of the great vessels and the heart, endocarditis, pericarditis, myocarditis, arteritis of the coronary vessels, and granulomatous aortitis may occur in rheumatoid arthritis.
Unlike rheumatism, with rheumatoid arthritis the inflammation is persistent - pain and swelling of the joints can last for years. This type of arthritis differs from arthrosis in that the pain does not increase with load, but, on the contrary, decreases after active movements.
American Rheumatological Association Diagnostic Criteria for Rheumatoid Arthritis (1987). The presence of at least 4 of the following signs may indicate the presence of the disease:
A blood test shows the presence of inflammation in the body: the appearance of special inflammatory proteins - seromucoid, fibrinogen, C-reactive protein, and rheumatoid factor.
Making a diagnosis of rheumatoid arthritis is possible only by assessing the entire set of symptoms, radiological signs and laboratory diagnostic results. If the result is positive, treatment is prescribed.
In case of accurate diagnosis of rheumatoid arthritis, systemic treatment involves the use of certain groups of drugs:
At the present stage of development of medicine, the following goals are set in the treatment of rheumatoid arthritis:
Treatment consists of a complex of methods of drug therapy, physiotherapy, nutritional therapy, surgical treatment, sanatorium treatment and subsequent rehabilitation.
This group of drugs is not included in the basic therapy of rheumatoid arthritis, since it does not affect the destructive process in the joints. However, drugs from this group are prescribed to reduce pain and eliminate stiffness.
Most often used:
Prescribed during periods of exacerbation of pain and severe stiffness. Prescribed with caution to patients with gastritis.
In combination with hormones, they help reduce the activity of rheumatoid arthritis. The most common drugs for treatment currently are:
There are also reserve drugs: cyclophosphamide, azathioprine, cyclosporine - they are used when the main drugs do not give the desired effect.
Monoclonal antibodies to certain cytokines neutralize tumor necrosis factor, which in the case of rheumatoid arthritis provokes damage to its own tissues.
There are also studies suggesting the use of lymphocyte differentiation regulators as a treatment for rheumatoid arthritis. This will avoid damage to the synovial membranes by T-lymphocytes, which are incorrectly “directed” to the joints by the immune system.
These are hormonal drugs:
They are prescribed both in the presence of systemic manifestations of the disease and in their absence. Today, in the treatment of rheumatoid arthritis, treatment is practiced with both small and large doses of hormones (pulse therapy). Corticosteroids are excellent for pain relief.
According to reviews, methotrexate for rheumatoid arthritis is actively prescribed in Russia and European countries. This is a drug that inhibits cells of the immune system, prevents the occurrence of inflammatory processes in the joints and aggravates the course of the disease. Now it is used very widely.
The drug has several side effects, so it is used under the close supervision of the attending physician; during the course of treatment, the patient must regularly undergo blood tests. Despite this, methotrexate for rheumatoid arthritis is the most appropriate solution, and in some cases it is simply irreplaceable.
The price of the drug varies depending on the form of release in the range from 200 to 1000 rubles.
Only after the acute form of the disease has been relieved, blood tests and temperature are normalized - massage and other methods of physiotherapy for rheumatoid arthritis can be used. The fact is that physiotherapy has a stimulating effect and can intensify the inflammatory process.
These methods improve blood supply to the joints, increase their mobility, and reduce deformation. Phonophoresis, diathermy, UHF, ozokerite and paraffin, infrared irradiation, therapeutic mud, and balneotherapy at resorts are used. We will not dwell on these methods in detail.
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:
Rheumatoid arthritis is primarily a medical problem. Therefore, surgery is reserved for those who are under the supervision of an experienced rheumatologist or doctor.
For rheumatoid arthritis, a special diet is recommended that will reduce inflammation and correct metabolic disorders.
The rules of the diet are as follows:
Treatment with folk remedies involves the use of medicinal plants that have analgesic and anti-inflammatory properties.
At home, you can make compresses, rub in homemade ointments, and prepare decoctions. It is important to follow the correct eating style, which helps restore metabolism in the body.
Prevention of the disease and its exacerbations is aimed, first of all, at eliminating risk factors (stress, smoking, toxins), normalizing body weight and maintaining a balanced diet.
Compliance with these rules will help avoid disability and prevent the rapid progression of RA.
Rheumatoid arthritis shortens life expectancy by an average of 3 to 12 years. A 2005 study by the Mayo Clinic found that the risk of heart disease is twice as high in those with rheumatoid arthritis, regardless of other risk factors such as diabetes, alcoholism, high cholesterol and obesity.
The mechanism by which the risk of heart disease increases is unknown; the presence of chronic inflammation is considered a significant factor. It is possible that the use of new biological drugs can increase life expectancy and reduce risks for the cardiovascular system, as well as slow down the development of atherosclerosis.
Limited studies demonstrate a reduction in the risk of cardiovascular disease, while an increase in total cholesterol levels is observed while the atherogenic index remains unchanged.