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Rheumatoid arthritis

 Rheumatoid arthritis

Rheumatoid arthritis


Rheumatoid arthritis is a severe, chronic, inflammatory connective tissue disease that is most evident in the joints. In this disorder, the immune system attacks cartilage tissue, bones and, sometimes, internal organs. The most commonly affected joints are the small wrists, wrists, shoulders, knees and ankles. With appropriate health measures and lifestyle changes, sufferers can have a long and quality life.

 

What Is Rheumatoid Arthritis?

Causes of rheumatoid arthritis

Risk group

Symptoms of rheumatoid arthritis

What searches can be done?

Treatment / prevention of rheumatoid arthritis

Forecast

What Is Rheumatoid Arthritis?

In rheumatoid arthritis, a permanent inflammatory process that engages the synovium gradually destroys collagen, reducing the space in the joint and ultimately destroying the bone itself.

Rheumatoid arthritis is a chronic condition in which joints become inflamed, swollen, sore, stiff and lose function. The process begins in the synovium, the membrane that wraps the wrist, forming a protective bag. This bag is filled with a joint lubricant called synovial fluid. In addition to protecting the joints, this fluid supplies nutrients and oxygen to the cartilage, a smooth tissue lining the ends of the bones. Cartilage is made primarily of collagen, a structural protein of the body that forms a network of fibers and thus supports the joints. In rheumatoid arthritis, a permanent inflammatory process that engages the synovium gradually destroys collagen, reducing the space in the joint and ultimately destroying the bone itself. In progressive rheumatoid arthritis, cartilage destruction is accelerated when fluid and inflammatory cells accumulate in the synovial, forming a panus, a growth that consists of thickened synovial tissue. Panus produces more enzymes that destroy nearby cartilage, worsening the status of the affected area and attracting more inflammatory cells, thus making the inflammatory process repeat. Not only does this process affect the cartilage and bones, it also damages organs in other parts of the body.

 

Causes of rheumatoid arthritis

The actual causes are unknown. According to the most acceptable theory, the "trigger" of rheumatoid arthritis is a combination of several factors, including abnormal autoimmune response, genetic predisposition, and viral or bacterial infection.

The actual causes are unknown. According to the most acceptable theory, the "trigger" of rheumatoid arthritis is a combination of several factors, including abnormal autoimmune response, genetic predisposition, and viral or bacterial infection. The inflammatory process is a by-product of the immune system, which fights infection and heals wounds and injuries. In case of bodily injury or infection, white blood cells are mobilized, which release the body from all foreign proteins, such as viruses. Collections of white blood cells in the area of injury or infection cause the inflammatory process at the sites concerned. A healthy organism controls and limits inflammatory processes, but in rheumatoid arthritis certain defects, probably genetic in nature, support this process. Although much is known, the factors that lead to this self-destructive condition are still unknown. Scientists have identified a molecule named HLA-DR4, present in many patients with autoimmune disorders. In people with this genetic sensitivity, the immune system can be triggered to invade collagen proteins for similarity to some foreign antigen, such as. the Epstein-Barr virus. However, it is present in many people who do not have RA. Although many viruses and bacteria have been tested, it has not been proven to be the primary trigger of an autoimmune reaction and subsequent devastating inflammatory process.

 

Risk group

Rheumatoid arthritis is more common in women than men in the ratio of 3: 1. Although it most commonly develops between the ages of 30 and 60, the incidence increases with aging. The risk is increased in families with a history of rheumatoid arthritis.

Symptoms of rheumatoid arthritis

A characteristic symptom of rheumatoid arthritis is morning stiffness, which lasts at least half an hour. Swelling and joint pain last at least six weeks before rheumatoid arthritis is diagnosed.

A characteristic symptom of rheumatoid arthritis is morning stiffness, which lasts at least half an hour. Symptoms such as malaise, weight loss and fever may be the initial signs of rheumatoid arthritis. Some claim to be symptoms of a cold or flu, except, of course, that rheumatoid arthritis symptoms can last for years. Swelling and joint pain last at least six weeks before rheumatoid arthritis is diagnosed. Although rheumatoid arthritis develops almost regularly in the joints and joints of the fingers, it often affects the knees and ankles, in fact many joints. The pain is often symmetrical, but may be more severe on one side, depending on which hand is used more often. Inflamed joints are usually swollen and often feel warm when touched. In about 20% of cases, inflammation of the end arteries causes subcutaneous nodules or nodules of a size of pea or slightly larger. They are located near the elbows, although they can develop anywhere else. Nodules are usually painless, rarely detecting the presence of rheumatoid vasculitis, a condition that affects the blood vessels of the lungs, kidneys, or other organs. Fluid buildup is possible, especially in the knees. In rare cases, it occurs in the joint sac behind the knee and forms a Baker cyst resembling a tumor, sometimes extending down the leaf of the leg, causing pain.

 

What searches can be done?

Blood tests may suspect possible rheumatoid arthritis.

Diagnosing rheumatoid arthritis is not easy. It can resemble many other conditions and its symptoms develop insidiously. Blood tests and X-rays can be normal for months after the onset of joint pain. Blood tests may suspect possible rheumatoid arthritis. These searches are:

rheumatoid factor,

erythrocyte sedimentation rate (SE),

C-reactive protein (CRP).

In almost 80% of cases of rheumatoid arthritis, blood tests reveal a rheumatoid factor, although it is not always specific for rheumatoid arthritis and can also be present in the blood of patients with other diseases. Erythrocyte sedimentation indicates the rate at which the erythrocytes fall to the bottom of the test tube with the patient's blood. The faster the sedimentation, the more severe the inflammation. Sedimentation can be high in many other conditions, but it is not the same in infection, inflammation and tumors. High levels of CRP are an indicator of acute inflammation. X-rays usually did not help in the early diagnosis of rheumatoid arthritis because they do not show soft tissue. Some experts believe that dual x-ray absorptiometry would help in early and accurate diagnosis and thus help determine the appropriate therapy.

 

Treatment / prevention of rheumatoid arthritis

The goal of most drug therapies is the long-term reduction of the inflammatory process, the prevention of bone and joint ligament damage, the preservation of motility, the greater cost-effectiveness of treatment, and the absence of side effects.

Rheumatoid arthritis is treated with medication and lifestyle changes. Many remedies are used to eliminate pain and slow the progression of the disease, but there is no appropriate treatment program yet. The goal of most drug therapies is the long-term reduction of the inflammatory process, the prevention of bone and joint ligament damage, the preservation of motility, the greater cost-effectiveness of treatment, and the absence of side effects. Initially, non-steroidal anti-inflammatory drugs (NSAIDs) are usually used to reduce pain by reducing inflammation. NSAIDs can cause side effects such as indigestion and digestive tract bleeding. If after approximately 4-6 weeks of administration they do not prove effective, the therapy is supplemented with other preparations. Traditionally, second-line anti-rheumatics have been used in so-called "second line" therapy. slow-acting antirheumatics. They are more effective than NSAIDs and can improve bodily functions in the long run. Some commonly prescribed antirheumatic agents are hydroxychloroquine, gold salts and sulfasalazine. Some experts recommend that patients with moderate to severe rheumatoid arthritis begin treatment with antirheumatic drugs immediately, with or without NSAIDs. Indicators for the immediate and aggressive introduction of antirheumatics are mild progression, involvement of parts of the body with exclusion of joints, high levels of rheumatoid factor and genetic markers. Corticosteroids reduce inflammation and slow joint damage. In the short term, they can improve the condition, but if applied for months or years, they can lose their effectiveness and cause serious side effects. Other drugs used are immunosuppressants and tumor necrosis factor (TNF) blockers. These preparations can cause severe side effects, such as increased susceptibility to infections and diseases. General measures: regular exercise, weight control, healthy eating, use of warm and cold therapeutic procedures (depending on the stage of the disease), relaxation techniques and taking recommended medications.

 

Forecast

Treatment is increasingly effective in slowing down this disease that causes disability, and sometimes aggressive anti-inflammatory drugs can prevent initial damage. Therefore, it is important that the patient first consult a physician.

Some experts classify rheumatoid arthritis into type 1 and type 2. Type 1 is a rarer form that lasts for up to several months and leaves no permanent disability. Type 2 is a chronic form that lasts for years, sometimes for a lifetime. Treatment is increasingly effective in slowing down this disease that causes disability, and sometimes aggressive anti-inflammatory drugs can prevent initial damage. Therefore, it is important that the patient first consult a physician. It should be emphasized that side effects of medicines often add to the severity of the disease. The affected joint can be deformed, and even the most ordinary movement can be very difficult or impossible. Rheumatoid arthritis causes anemia and engages nerves. They are at risk for scleritis, an inflammation of the blood vessels of the eye that can cause corneal damage. The disease also carries a high risk of haematological tumors, the development of which may be affected by changes in the immune system. Aggressive drugs that suppress the immune system may prevent the development of these tumors, but much more research is needed to rule out this possibility. Although type 2 is progressive and incurable, over time the disease becomes less aggressive and the symptoms can be alleviated. The fracture and deformities of the bones and ligaments are a lasting consequence. The long-term prognosis of juvenile rheumatoid arthritis can be very serious. Although usually withdrawn before puberty, research conducted on individuals diagnosed with juvenile rheumatoid arthritis 25 years back showed that they had greater pain, weakness, and general impaired physical function than people without a history of the disease.



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