Rheumatoid Arthritis - Causes, Symptoms and Treatment .MF .
Rheumatoid arthritis - a disease of the joints, in which, as a rule, affects symmetrical joints of hands and feet.This disease occurs in 1-2% of the world population, mostly women suffer from middle-aged and elderly.
Causes Rheumatoid Arthritis Rheumatoid arthritis
refers to autoimmune diseases, ie diseases that arise in violation of the normal functioning of the immune system.Like most autoimmune pathologies, the exact cause of the disease is not detected.It is believed that provoking factors for the disease are:
• Genetic predisposition .It was found that relatives of patients with rheumatoid arthritis is a disease develops more often.Also grows the likelihood of developing rheumatoid arthritis in patients with some other autoimmune diseases (systemic lupus erythematosus, glomerulonephritis).
• Infections .Typically, rheumatoid arthritis occurs after undergoing measles, herpes infection, hepatitis B, mumps.
• Adverse factors external and internal environment .This may be hypothermia, exposure
Under the influence of these factors, immune system cells begin to attack the cell casing joint that causes inflammation.In this case the joints swell, become hot and painful to the touch.Cells of the immune system and cause a loss of blood vessels, which explains the so-called extra-articular manifestations of rheumatoid arthritis.
Possible symptoms of rheumatoid arthritis
disease begins gradually.At the initial stage affects the small joints of the hand (phalanges), rarely stop.
Favourite localization of inflammation in the wrist in rheumatoid arthritis
In the morning, patients complain of morning stiffness - it is impossible to comb your hair, take a toothbrush, fasten buttons, make breakfast, because the fingers are not unbend.Depending on the time during which keeps stiffness in the joints, are the following degree of rheumatoid arthritis activity.
For first degree activity is characterized by the duration of morning stiffness of the joints 30-60 minutes, second degree - up to 12 hours.When third maximize stiffness constant activity persists throughout the day.Affected joints are moderately swollen, the skin over them hot to the touch, but the usual color.For
characteristic of rheumatoid arthritis pain in the joints, which first appear in motion and with the progression of the disease and at rest.In medicine, for the convenience of patients accepted visual analog scale (VAS) pain.It is a 10 centimeter line on the front side of which there are only two marks.0 corresponds to the inscription "no pain", 10 - "maximum pain".The patient was asked to evaluate the intensity of their pain, considering how far away his pain compared to the pain of such a force, which he can imagine.The doctor then measures the distance in centimeters from zero to mark the patient.Less than 3 cm VAS scale corresponds to the first degree of rheumatoid arthritis activity, a second 3-6 cm, 6 cm and a point on the third level of activity.
Unfortunately, pain in the joints dramatically impairs their function.The ability to self-service, the implementation of professional and non-professional activities is the basis of allocation of functional classes of disease.
Functional classes of rheumatoid arthritis
As the progression of the disease develop various joint deformities, the most typical of which are represented in the figures below.Unfortunately, these changes are irreversible.
deformation of the hand joints of the type "fin walrus»
Deformation joints brush of the type "swan neck»
deformation of the hand joints of the type "Button sewing loop»
extra-articular manifestations of rheumatoidarthritis are also characteristic.From the first weeks of the disease in patients is reduced body weight.With a high degree of arthritis activity, weight loss can be up to 10-20 kg for 5 months.Patients concerned about the increase in body temperature to 37-39 ° C, often in the evening and at night.Also affected muscles: the patient complained of pain on movement, severe muscle weakness.A characteristic feature of rheumatoid arthritis are rheumatoid nodules.
Rheumatoid nodules on the fingers of the hand in rheumatoid arthritis
This painless dense rounded education up to 2-3 cm in diameter.They placed subcutaneously in the joints of fingers, elbow joints.The appearance of rheumatoid nodules indicates a high degree of disease activity.Moreover, in patients with rheumatoid arthritis may occur an increase in the spleen, lymph nodes, pleuritis, interstitial pneumonitis, myocarditis, pericarditis, glomerulonephritis.
diagnosis of rheumatoid arthritis
In 1997, the American College of Rheumatology diagnostic criteria have been proposed for rheumatoid arthritis, which are relevant to this day.If any 4 of 7 of these criteria the diagnosis is considered to be reliable.
• Morning stiffness of joints that lasts for more than 1 hour for 6 weeks.
• Defeat three or more joints.
• Defeat hand joints.
• Symmetry defeat, that is, the disease of the same joint on the left and the right.
• Rheumatoid nodules.
• A positive rheumatoid factor.
• Characteristic radiographic changes.
Unfortunately, these features can be found only in the later stages of the disease.Therefore the appearance of symptoms of morning stiffness, swelling or soreness in the joints brush is recommended as soon as possible address to the rheumatologist. Early forms of rheumatoid arthritis is much better to treat.
The laboratory analysis revealed the following changes:
In the analysis of blood: decrease in hemoglobin concentration and a decrease in the number of red blood cells, platelets, against the backdrop of accelerated ESR (erythrocyte sedimentation rate).In addition, patients with rheumatoid arthritis increasing concentration of inflammatory factors, such as C-reactive protein, gamma globulin.
Noteworthy presence of rheumatoid factor in the blood. Rheumatoid factor - is a special substance, which is released by the immune system to fight the joint membrane cells.Identification of this indicator in the blood speaks not only about the presence of rheumatoid arthritis, but also characterizes the degree of activity of the process.
fundamental importance for the diagnosis of rheumatoid arthritis is joint radiography , as a rule, the joints of the hands and feet.Narrowing of the joint cracks and signs of bone loss in areas adjacent to the joint, favors the rheumatoid arthritis.
Rheumatoid Arthritis Treatment
Treatment should be directed at reducing the activity of the process, to reduce pain, stiffness in the joints, as well as the prevention of complications.
Features of diet and lifestyle in the treatment of rheumatoid arthritis
Proper nutrition plays a big role in the treatment of rheumatoid arthritis.It is found that some products, most patients promote occurrence of complications.Patients with rheumatoid arthritis are advised to completely exclude them from the diet.These products include: fatty meat, milk, citrus fruits, corn, oat and rye grains.Positive action has a vegetarian low-fat diet.Embodiments of the right diet is a diet Dong, the Inuit diet, or cheese-vegetable diet, which has been used successfully in Finland.
Drug treatment of rheumatoid arthritis
pronounced anti-inflammatory and analgesic properties have non-steroidal antiinflammatory drugs (NSAIDs) such as diclofenac, deksalgin, nimesulide, meloxicam, and the glucocorticoid prednisolone.These drugs can be used in the early stages of development in a specific pattern of disease.A side effect of NSAIDs is their adverse effect on the mucosa of the gastrointestinal tract, which manifests the development of ulcers.Corticosteroids reduce the immune system, cause bone loss, diabetes, a specific type of obesity, as well as exacerbation of existing chronic diseases.
To reduce the activity of rheumatoid process used drugs such as D-penicillamine, methotrexate, azathioprine, cyclophosphamide.Their common feature is the suppression of immune system activity.Therefore, during treatment, the patient becomes quite susceptible to infectious diseases.In addition, these drugs exhibit high toxicity, which is manifested in changes in the blood, renal disease, liver, lungs and other organs.
addition to drug therapy for the removal of circulating inflammatory agents provocateurs shown holding hemosorption (removal of certain substances from the blood by fixing them on sorbents) and plasmapheresis (plasma removal of hazardous substances and replacing it with the same volume of donor plasma).
Local treatment is administered anti-inflammatory drugs (diprospan) into the joint cavity, as well as on the joint application of ointments, gels containing NSAIDs.
primary cause of degenerative and inflammatory diseases of the musculoskeletal system is to reduce the levels of glucosamine and chondroitin, a natural component of the cartilage of the joint.Therefore, in addition to drugs, relieves pain, used tools, reducing the joints.The optimal dose for the assimilation of such components is available in the complex "Glucosamine Maximum" from Natur products that help restore and protect against the destruction of cartilage.Means are widely used in modern medicine for the treatment and prevention of various diseases of the joints.
In combination with drugs for the topical treatment of inflammation applied physiotherapy.It may be recommended ultraviolet irradiation of joints, magnetic therapy, electrophoresis of anti-inflammatory drugs, laser therapy.Massage and physiotherapy prescribed for calming inflammation.
When expressed deformation of joints, surgical treatment.Currently used successfully removing the damaged portion of the shell, or the whole joint with subsequent prosthetics.As a supportive treatment is recommended wearing orthoses - special devices that should be put on the affected limb, usually at night, and by maintaining a certain shape does not allow to deform the joints.
Possible complications of rheumatoid arthritis
Most complications in rheumatoid arthritis is associated with toxic effects of drugs for treatment.At the same time, patients may develop secondary amyloidosis, osteoporosis (bone loss) or in violation of hematopoietic system.
Amyloid - a large insoluble protein that is produced in excessive amounts during inflammation and is deposited in various organs and tissues.Most dramatic is the deposition of amyloid in kidneys.This condition is not curable, patients soon formed end-stage renal failure.
Due to chronic inflammation is a decrease in bone density, bones become brittle.For this complication characterized by fractures with minimal impact even including spontaneous.After bone fractures grow together for a long time, often false joints are formed.
Causes of the hematopoietic system has not yet been studied.However, patients with high disease activity bone marrow is replaced by scar tissue.The reduced concentration of blood cells develop severe incurable condition.
In addition, in case of late treatment of severe deformation of the brush are formed joints.This dramatically reduces the ability to work sick, eventually leading to disability.
Forecast of development of rheumatoid arthritis Rheumatoid arthritis
refers to diseases with a poor prognosis.This means that, despite treatment, it is impossible to achieve a complete recovery.In addition, preparations for the treatment are extremely high toxicity.The life expectancy of patients with rheumatoid arthritis by an average of 5-10 years less than the general population.In these patients, due to the constant chronic inflammation are at increased risk of sudden cardiovascular death, internal bleeding, infectious complications.
Prevention of rheumatoid arthritis
Given the autoimmune nature of the lesion, specific preventive measures can not be developed.The general recommendations are: avoid hypothermia, exposure to toxic substances, psycho-emotional voltage, timely and effective treatment of infections.To prevent the development of complications is necessary even with minimal signs of disease to turn to the rheumatologist.
therapists Sirotkin EV