Rheumatoid Arthritis

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What is Reumatoid Arthritis
rheimatoid artritis

Rheumatoid arthritis (or simply arthritis) is a chronic, progressive, systemic disease mostly damaging the joints; unfortunately, it can also damage the heart, kidneys and eyes. Rheumatoid arthritis affects people of all ages, more often – women.

Causes

Exact causes of rheumatoid arthritis are still unknown. Rheumatoid arthritis is considered to be caused by genetic factors and viruses. Essence of the disease is dysfunction of the immunity. Immune cells accumulate in the joints (bones, cartilage, surrounding tissue) and cause chronic inflammation. The inflammation causes destruction and scarring of the joints. Later the joints deform and loose their structure.

Signs and Symptoms

Rheumatoid arthritis causes changes in the fingers or, less frequently, the knees and wrists as well as other joints of the body. Mostly the joints are affected symmetrically (the same joints in both hands and legs). Rheumatoid arthritis often develops slowly (subacute progress). Rarely an acute disease might begin accompanied by fever and chills.  The disease usually begins with swelling, redness and severe pain in the joints mentioned above. These joints are usually stiff (for hours) in the morning. When the disease progresses, the inflammation of surrounding tissues, muscle atrophy and joint deformity occur. In rare cases rheumatoid arthritis can damage the spine, elbows and knees.  In severe cases these patients can no longer perform basic tasks. It is very specific for rheumatoid arthritis to cause inflammation of tendons and bursas (carpal tunnel syndrome, Baker popliteal cyst).

In 20 % of the patients the disease damages other organs – peripheral nerves (neuropathy), the blood vessels (vasculitis), heart (rhythm and conduction disorders), lungs (fibrotic alveolitis) and kidneys (amyloidosis).

Diagnosis

Blood tests are not specific – an increase of inflammatory indices as well as anemia might be noticed. Some forms of rheumatoid arthritis have a special indicator in the blood (an antibody) – the rheumatoid factor (although it is found in patients with other diseases).

Another diagnostic method of rheumatoid arthritis is rentgenography. According to radiological signs rheumatoid arthritis is divided into four stages.

Treatment

The main treatment of rheumatoid arthritis is physiotherapy and massages. It is important to reduce inflammation and pain, also, to reduce the progression of arthritis.

Correct regimen (it spares the damaged joints) and exercise (it is important to choose correct exercises) are also important. Drugs used to treat rheumatoid arthritis: nonsteroidal anti-inflammatory drugs (particularly diclofenac, indomethacin, ibuprofen), glucocorticoids (prednisone, methylprednisone). In severe cases immunosuppressive drugs (methotrexate, sulfasalazine) are used.

Prognosis

The prognosis of rheumatoid arthritis depends on the progression of the disease and the damage of internal organs. The prognosis is good if there is no damage of the internal organs. However, rheumatoid arthritis may eventually lead to irreversible joint damage and disability.

   

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