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Causes, symptoms, stages and diagnosis of rheumatoid arthritis

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A disease called rheumatoid arthritis is a very common disease which affects approximately 1.8% of the population. Women suffer more often than men. So, one affected man have up to 4 women. It is not necessary to think that rheumatoid arthritis is a disease of the elderly, just over the years, she increasingly worse and begins to affect people it is quite young, being aged 35 years and older. The disease is progressive and eventually leads to disability with restriction of ability to movement.


What is rheumatoid arthritis?

Rheumatoid arthritis is one form of arthritis a chronic nature, which differs in that it affects joints on both sides of the body, which is his hallmark. This is the disease which leave without attention is almost impossible. Because in addition to joint damage, it eventually will affect the internal organs and affect their functionality.

There are many definitions of the disease, but they all boil down to the fact that the disease that bears autoimmune in nature and affects the small peripheral joints, characterized by erosive and destructive nature.

Here are a few facts about this disease:

  • It is an autoimmune disease that is very dangerous and leading to inflammation of the joints mostly of the feet and hands and other parts of the human body.
  • The disease has no boundaries and affects people of any age, even children.
  • Not always with accuracy, you can establish the causes that led to the development of the disease.
  • The disease is characterized by frequent remissions and periods of outbreaks and extinction.

  • Most often joints are affected symmetrically.

  • The speed of progression of the disease can be both small and fast, and is not determined by the severity of symptoms.
  • The treatment most successfully in the case that it was developed before the disease spilled over into the chronic form.
  • In extremely rare cases, but still found spontaneous remission of the disease (the so-called "self-treatment").

If we turn to the classification of disease, clinical and anatomical features distinguish the following types of arthritis:

  • Disease-type poly-, mono - or oligoarthritis.
  • Having systemic symptoms.

  • Arthritis with diffuse lesions of the connective tissue, accompanied by osteoarthritis, wearing a deforming character, as well as rheumatism.

  • Special nonspecific forms uvenilny arthritis (the one that affects children under the age of 16 years), Felty syndrome and stilla (characterized by the accession of other diseases).
On immunological characteristics can be divided rheumatoid arthritis in two options:

  • Seronegative, joint fluid, or rather in her serum, there is no rheumatoid factor.
  • Seropositive when rheumatoid factor is present and can be identified.

Rheumatoid arthritis haunting humanity for many centuries, the first signs of disease, was discovered on the bones of skeletons of Indians, which existed 4,500 years BC.

The characteristics of the disease include the following features:

  • This is a chronic ailment that haunts a person for years, impacting on his quality of life, and sometimes even asymptomatic. But, unfortunately, the last option is extremely rare. And most often, the arthritis progresses and leads to the fact that a person becomes disabled.
  • Inflammation can occur as the tissue located around them (sometimes the affected muscles, ligaments and tendons) and within the synovial bags.
  • Sometimes the disease leads to the fact that cartilage, ligaments and bones are destroyed and the joint is severely deformed. Studies have shown that the joints can undergo deformation even at the initial stage of the disease, regardless of the severity of pain and other symptoms. This applies to the progressive course of the disease.
  • The disease can affect a person of any race, no matter what he does the way of life. Often rheumatoid arthritis is observed in all family members who follow an active daily routine, nutrition, and prefer sports. That, according to scientists, proves the existence of genetically causing the emergence of the disease.

The causes rheumatoidarthritis

Surprisingly, despite this considerable age of this disease, the causes leading to the development of the disease are still not identified.

Although, of course, some assumptions of the modern scientists still are:

  • Autoimmune diseases. As one of the reasons for the development and progression of disease are a variety of disease that "confuse" the immune cells of the body. Instead of fighting bacteria and viruses that affected person, the immune system begins to attack healthy tissue, and primarily affects the joints. Lymphocytes are actively attacking them, trying to destroy, as something alien to the body. To cause that kind of aggression can be any disease, but rheumatologists noted that almost half of the patients had permanent SARS, frequent sore throats and the flu. There is a theory that in the joint capsule can accumulate particles of viruses, and the immune system, mistaking them for enemies, trying to fight them.

  • Rheumatoid arthritis can be a logical "sequel" to the infectious arthritis or reactive bearing, which is formed on the background of injuries or hypothermia.

  • There is also a version that the disease may occur on the background of strong emotional shock. So half of the patients with a diagnosis of rheumatoid arthritis, noted that the disease arose from them after suffering a stress (death, divorce or other factor). Scientists also noticed some similarities in most patients. This people are very emotional and impulsive. Therefore, the disease most often affects women, with their hormonal changes in the body. Moreover, it is noticed that those people who have arthritis started on the background of suffering colds and imposed on them the emotional turmoil of the illness is much more complicated served therapy and progresses faster.

  • Some scientists believe that the cause of arthritis may be lurking in the gut when the immune system tries to eliminate the opportunistic bacteria living in it. The result of this struggle may develop this disease.
  • Not worth it as a reason to ignore and genetics. So children whose older relatives suffered from or are suffering from the disease are also more susceptible to development of rheumatoid arthritis in the future. And long time before genes were evenhighlighted.
  • Environmental factors are the conditional causes of the disease. Smoking and the consumption of plants treated with the chemicals, particularly silica, leads to diseases of the oral cavity, and also to arthritis.

Some experts have expressed the opinion that rheumatoid arthritis cause certain viruses, which at the time of diagnosis of the disease is eliminated from the body. But still this version has not found its confirmation. Therefore, as the main risk factors considered to be genetic predisposition, infectious diseases, emotional turmoil and the adverse impact of the external environment.


Symptoms of rheumatoid arthritis

If the causes of this disease is not completely well established, the symptoms are exactly known:

  • Its development the disease begins in the metacarpophalangeal joints, affecting also lucysebastian. In the first stages suffer from the small joints of the hands, legs, feet, wrists, shins and elbows.
  • Affects both arms or legs, that characterizes rheumatoid arthritis like disease with symmetrical grip the joints.
  • The patient begins to experience pain, which may subside after the implementation of active movements. This is a crucial symptom that allows to distinguish this species from the rheumatic arthritis. After some time the disease progresses, and movement do not help.
  • The pain syndrome often accompanies people in the first half of the day, especially in the morning, making the usual Commission procedures (brushing teeth, Breakfast) is very difficult. By evening, the pain subsides, and in the morning all repeated. But in advanced stages of the disease, the pain does not fade away even for the night time.
  • The person experiences morning stiffness, body if seacsea.
  • During the acute phase of the disease, the skin around the joints may be red and to the touch they will be hot.
  • Over time in the pathological process involved the larger joints. Rheumatoid arthritis leaves no "focus" knees and shoulders. They almost never affected the first. In individual cases, the disease can affect the spine and the hip joints.

  • Overall health deteriorates significantly, there is a rise in body temperature,the appetite fades, patients complain of not passing weakness. Against this background one begins to lose weight.

  • A typical symptom is the presence of subcutaneous nodules, which are located in the region of the joints of patients. They may at some time disappear and then appear again. Their diameter usually does not exceed 2 cmthey are round in shape, fairly dense and often moving. Can sometimes occur in quite unexpected places – at the back, in the forearm, and sometimes on internal organs (the lungs and the myocardium).

  • Rheumatoid arthritis causes deformation of the joints, poor circulation and slow muscle atrophy. Man is not only incompetent, but later on we will not be able to care for themselves, as the joints lose their mobility.

  • Sometimes the symptoms are nonspecific and affect the salivary gland, causing inflammation. Some patients report pain in the eyes, numbness and discomfort in the chest, especially in the implementation of deep breaths.
  • Symptoms such as asthenia, arthralgia, and increased sweating are constant companions of the sick person.
  • People become sensitive to the weather and complain of increased pain when weather changes, atmospheric pressure and changing seasons.
  • Reduced sensitivity of the limbs.

Over time, if rheumatoid arthritis takes quite seriously and for a long time, patients experience the following symptoms:

  • Affects the major muscles, particularly the thigh and gluteal muscles, affects the extensors of the forearm.

  • The skin becomes dry and thin, nails are formed necrosis, threatening to become gangrenous. The plates themselves are your nails constantly break, striated bands and poorly restored.

  • Can affect the gastrointestinal, nervous, pulmonary, and visual system. Violations occur in the work of the heart and blood vessels.

  • On the body can develop rashes and ulcers occur bleeding as uterine and nasal.


Stage of rheumatoid arthritis

There are several criteria by which to classify development stages of rheumatoid arthritis, but the most informative are those that are based on the testimony ofx-ray images.

They are divided into four categories:

  • At the initial stage are seen the first signs of thinning bones, is practically the only manifestation that you can see in the picture. The soft tissues around the joints thicken and become slightly thicker. Sometimes there are noticeable bright areas on bone tissue is formed cyst. When the joint gap is narrow, then we can say that the disease is progressing and soon will move to the next stage. A characteristic feature of this stage of development of the disease is that it can occur at any age and leaking for quite a long time practically does not prove itself. Sometimes a similar condition is found even in childhood, and the disease first manifests itself after many years.
  • The second stage is characterized by the fact that in addition to the intricacies of bone, localized predominantly around the joint, begins to wonder about the bone itself in the erosive type. Primarily affects the arms elbows and wrists. If the erosion is near the cartilage, in this case, there is a limitation. However, the tissue may be deformed, but muscles begin to atrophy, especially those that surround the patient's joint. Bursal edematous and slightly inflamed. During an exacerbation they can be hot, and the patients in the second stage of the disease complain of pain and aching. The more erosion on the bone, the closer the third stage of disease progression.
  • At this stage, visible not only damage bone and its refinement, here the picture shows clearly seen atrophy of the muscles, wearing a broad nature, the joint is already affected by deformation. If the accumulation of salts begins at the first stage, the third calcification is visible on x-ray. While deposits can be of different size and shape. Their structure can also vary from dense to quite loose. The joints at this stage is already significantly limited in motion.

  • The fourth stage is the stage where noticeable bone disorders. X-ray examination detects osteoporosis, visible erosion, and cysts which are multiple slits may coalesce, or have extremely narrow gaps. The joint is fully deformed, the muscles and soft tissue around it atrophied. The disease affects all the limbs, and patients complain of intense and persistent pain.

Depending on the state and on its functionality, there are also four stages of disease development:

  • At firststage, the patients are able to independently perform all everyday activities, their General condition is not broken, the pain symptoms do not exist.
  • In the second stage, people maintain fitness, but everyday activities to cope with work, exercise become difficult.
  • In the third stage, patients are usually restricted in their work activities, but able to cope with the service itself.
  • At the fourth stage, the person cannot perform any activity.

Diagnosis of rheumatoid arthritis

Diagnosis rheumatoid arthritis can be complicated due to the similarity of its symptoms with several other diseases. So, it is possible to confuse this disease with acute rheumatic fever, Lyme disease, gout, osteoarthritis and other joint diseases.

In 1997 the College of rheumatology has proposed criteria, which are taken in a basis of definition of rheumatoid arthritis.

If most of them are observed in patient who came for examination, the doctor the right to put this diagnosis:

  • More than three affected joints.
  • Affected joints of the hand.
  • In the morning, the person feels a sense of stiffness, which disappears after not less than one hour. Such feelings disturb the patient more than 1.5 months.
  • The lesions are symmetrical.
  • There are specific knots.
  • X-ray shows characteristic changes, regardless of the stage of the disease.
  • Rheumatoid factor – positive.

As laboratory research was to focus on the following indicators:

  • The blood test clearly shows the reduction of hemoglobin and red blood cells, erythrocyte sedimentation rate accelerated, and the number of platelets is reduced. Gamma-globulin and C-reactive protein higher than the norm.
  • The blood examined for the presence of rheumatoid factor, if this index is present, then it is possible to understand also how actively started the process of development of the disease.
  • Doctors must prescribe x-ray examination, which is the base for determining the presence of the disease.
  • Sometimes there may be enlargement of the spleen.
  • Forexamination under a microscope doctors can collect synovial fluid or biopsy of the nodules.

Timely diagnosis of the disease will enable the application of adequate therapy, the sooner that is started, the more effective the treatment and the less risk of complications.

Meanwhile they can be quite serious and are expressed in the following:

  • Skin diseases such as vasculitis ulcers, dermatitis and rheumatoid nodules.

  • Diseases of the pulmonary system, which are expressed in the pleurisy and formation of these same nodules.
  • Diseases of the visual apparatus, which can be expressed as a small irritation and severe inflammation of the eyeball with subsequent loss of vision.
  • In diseases of the blood system, causing anemia and thrombocytopenia.

  • In pathologies of the cardiovascular activity that can end up as a heart attack, and stroke.


How to treat rheumatoid arthritis?

As the main modern methods of treatment of rheumatoid arthritis, it is common to use:

  • Basic therapy.
  • The use of anti-inflammatory drugs.
  • Physical therapy combined with local treatment.
  • Diet and traditional medicines.

Depending on the severity of the symptoms of the disease, and the nature of its occurrence and speed of progression used a variety of methods of treatment. They vary widely, ranging from normal rest and adequate nutrition, which is Advisory in nature and ending of potent drugs. But, as a rule, treatment in the initial phase is gentle in nature, if this does not help, then move on to more radical methods of treatment.

It is based on the principle of providing rest to the affected joint, as more load leads to increased inflammation. Sometimes for a short time, patients are prescribed bed rest with immobilization of several joints. For this, acupuncture is applied to the affected areas of the tyres.

As modern medicines doctors prescribe several groups of drugs, when indicated:

  • As a non-steroidal anti-inflammatory drug usedibuprofen and aspirin. They are able to relieve swelling and swelling in the tissues, and significantly reduce the symptom of pain. Aspirin is quite outdated treatment for rheumatoid arthritis and has a lot of side effects, so in recent years doctors are trying to replace modern medicines such as ibuprofen. It is not so much irritating to the stomach, but nevertheless it is absolutely harmless to call it impossible.

  • If NSAIDs do not bring relief, and do not give the desired effect throughout the their regular use in 3 months, the doctors Supplement treatment medication for long periods. These include sulfasalazine, penicillamine, plaquenil and gold link. They often have a pronounced effect on the course of the disease, but their major drawback is that side effects resulting from administration of these drugs can be very serious. They have a negative impact on the kidneys, liver, cause skin itching and diarrhea, can lead to bone deformation. If you begin to manifest such side effects, the drug immediately overturned. But in some cases it is possible to inhibit the development of rheumatoid arthritis quite a long time, the drugs are used in low dosage and do not allow serious complications to other organs and systems.

  • For the treatment of rheumatoid arthritis use prednisone, which belongs to the class of corticosteroids. They are effective, but their disadvantage is that after a short time the products cease to influence the course of the disease. Because this disease is chronic, corticosteroids are used only for short-term relief of sick joints.

  • Drugs such as azathioprine, methotrexate and cyclophosphamide belong to the class of immunosuppressants, and are effective in case of severe disease. They are very effective but their major drawback is the severe side effects that are to lose the internal organs (lungs and liver), dysfunction of hematopoiesis, increasing the risk of bleeding and even cancer.

Drug therapy gives better therapeutic effect in the case when they are combined with therapeutic exercises, physiotherapy and the influence of both high and low temperatures (cryotherapy). Sometimes it may require surgical intervention. Highly effective water treatment when the lessons in the pool joints actively moving, but not experiencing a load.

With regard to surgicaltreatment, modern medicine has the ability to completely replace a diseased joint, on a similar but artificial. They are used to restore mobility in the knee or in the hip joint. Sometimes surgery is aimed at fusion of the joints, most often it is used when lesions of the feet rheumatoid arthritis. This way you can achieve a significant reduction of pain when walking.

Also for those people that caught this disease, modern medicine offers various auxiliary means, for example, special shoes or the means to capture subjects. All this greatly improves their quality of life and alleviates the pain symptoms.

Diet plays an important role for the treatment of the disease, since in such a situation the body needs the full receipt of all nutrients. With regard to limitations, it is necessary to reduce the consumption of salt, protein foods and fats of animal origin. At the time of acute illness it is important to fully abandon the use of sugar and alcohol.

Need to be mandatory to eat cottage cheese and drink milk drinks. The exception table should not be fresh fruit and vegetables as well as greens. Useful are grain and fish dishes. Rheumatologists argue that the strict diet contributes greatly to recovery.

See also: Diet for rheumatoid arthritis

Specific measures of prevention does not exist, however, doctors give some recommendations, observing that it is possible to somewhat reduce the risk of disease:

  • Elimination of foci of inflammation in the body which lead to decreased immunity, namely the treatment of angina, tonsillitis, sinusitis and carious teeth.

  • To prevent hypothermia.
  • To avoid a long stay in a stressful condition.
  • Give up bad habits, particularly Smoking.
  • Pay attention to the possible presence of hereditary factors and if any, more attentive to their health.
  • Treatment of viral infections under medical supervision.
  • The use of vitamin complexes especially dangerous periods.

    • See also: Allpossible methods of treatment of rheumatoid arthritis

    The doctor should be immediately contacted when the manifestation of characteristic symptoms such as bilateral inflammation of joints and pain. When the deformation of the bones, as well as the detection of small subcutaneous nodules. Should immediately call an ambulance if these symptoms are susceptible to temperature, painful sensations appear in the chest, breathing becomes difficult, and the cardiac activity is disturbed.

    It is worth remembering that if rheumatoid arthritis is characterized by rapid and aggressive course, with this disease it can be overcome, translate it into a chronic form and continue to live a full life, which in the end will not lead to disability.