Rheumatoid Arthritis : Definition, Other Names, Causes and Symptoms of Rheumatoid Arthritis, Treatment and medicines, SURGERY and PHYSIOTHERAPY

Rheumatoid Arthritis

Definition

It is a chronic disease that leads to inflammation of the joints and surrounding tissues. It can also affect other organs.

Alternative Names

RA, rheumatoid arthritis

Causes

Rheumatoid arthritis (RA) is considered an autoimmune disease and its cause is unknown. The body's immune system normally fights foreign substances such as viruses. But in an autoimmune disease, the immune system confuses healthy tissues or taking as foreign substances, and as a result, the body attacking itself.

Rheumatoid arthritis can occur at any age and women are affected more often than men.

Rheumatoid arthritis usually affects joints on both sides of the body equally, with the wrists, fingers, knees, feet, ankles and body parts most commonly affected. The course and severity of rheumatoid arthritis can vary considerably. Infection, genes and hormones may contribute to this disease.

Symptoms

The disease usually begins gradually with:

* Fatigue
* Inappetence
* Morning stiffness (lasting more than an hour)
* Muscle aches widespread
* Weakness

Finally, there is joint pain. When the joint is not in use for some time, may become warm, sensitive and rigid. When the lining of the joint becomes inflamed, produces more fluid and the joint swells. The joint pain is often felt on both sides of the body and can affect the wrists, knees, elbows, shoulders, hips, fingers, hands and feet, ankles and neck.

Additional symptoms include:

* Anemia due to insufficient bone marrow to produce enough new red blood cells
* Burning, itching and discharge from the eye
* Deformities of hands and feet
* Range of motion limited
* Fever
* Inflammation of the lungs (pleurisy)
* Round, painless nodules under the skin (usually a sign of a more severe disease)
* Numbness or tingling
* Paleness
* Redness or swelling of the skin
* Swollen lymph nodes

The destruction of the joint may occur in a matter of one to two years after the onset of the disease.

Examinations and tests

Availability of a specific blood test to diagnose and differentiate rheumatoid arthritis from other types of arthritis. This test is called a review of antipeptidos cyclic citrullinated antibodies (anti-CCP). Other tests that can be done include:

* Complete Blood Count
* C-Reactive Protein
* Erythrocytic sedimentation rate
* Ultrasonography and magnetic resonance imaging (MRI) of joints
* Radiographs of the joints
* Rheumatoid factor (positive in approximately 75% of people with symptoms)
* Analysis of the synovial fluid

Treatment

Rheumatoid arthritis usually requires lifelong treatment, including medication, physiotherapy, exercise, education and possibly surgery. Aggressive treatment and appropriate for this type of arthritis can slow the destruction of the joint.

MEDICINES

Medicines disease-modifying antirheumatic (DMARD stands for English) are the current treatment of reference for cases of rheumatoid arthritis, in addition to rest, strengthening exercises and anti-inflammatory drugs. Methotrexate (Rheumatrex) is the most commonly used DMARD for rheumatoid arthritis. Leflunomide (Arava) may be replaced by methotrexate. These drugs are associated with toxic side effects, so one needs frequent blood tests when you are taking.

Anti-inflammatory medications: These include acetylsalicylic acid (aspirin) and non-steroidal antiinflammatory drugs (NSAIDs) such as ibuprofen. Although NSAIDs work well, their prolonged use can cause stomach problems such as ulcers and bleeding, and possible heart problems. NSAIDs now come with warning labels on the product to warn users about an increased risk of cardiovascular events like heart attack or stroke, and gastrointestinal bleeding.

Antimalarial drugs: This group of drugs includes hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine), typically used in combination with methotrexate. However, it may take weeks or months to see any benefit of these drugs.

Corticosteroids: These drugs work well to reduce joint swelling and inflammation. However, due to the potential side effects long-term corticosteroids should be taken only for a short time and at low doses where possible.

Inhibitors of cyclooxygenase-2 (COX-2): These drugs block an enzyme called a promoter of COX-2 inflammation. Initially it was believed that these drugs work as well as traditional NSAIDs, but with fewer stomach problems. However, numerous reports of heart attacks and stroke have prompted the FDA to reassess the risks and benefits of COX-2. Celecoxib (Celebrex) is still available, but labeled with strong warnings and a recommendation that it be prescribed at the lowest dose and for the shortest time possible. Talk to your doctor about whether these COX-2 inhibitors are appropriate for you.

BIOLOGICAL AGENTS:

Specific modulators of white blood cells: These treatments control the inflammation and effectively include:

* Orencio (abatacept), applied under the skin (subcutaneous) or into a vein (intravenous) once a month. Reduce the number of T cells (a type of white blood cell).
* Rituxan (rituximab), applied under the skin or into a vein twice a year. Reduce the number of B cells (a type of white blood cell).

Inhibitors of tumor necrosis factor (TNF): This relatively new type of drug blocks a protein in the body involved in producing inflammation. Administered intravenously and directly include:

* Adalimumab (Humira)
* Etanercept (Enbrel)
* Infliximab (Remicade)

SURGERY

Occasionally, surgery is needed to correct severely affected joints. Surgeries can relieve joint pain, correct deformities, and modestly improve joint function.

The most successful surgeries are those performed in knees and hips. Usually the first treatment is surgical synovectomy or removal of the lining of the joint (synovial membrane).

A further alternative is total joint replacement with a prosthetic joint. In extreme cases, complete replacement of the hip or knee can mean the difference between total dependence on others and to live independently at home.

PHYSIOTHERAPY

The exercises range or range of motion and individualized exercise programs prescribed by a physiotherapist can slow the loss of joint function.

Joint protection techniques, treatments with heat and cold and the use of splints or orthotic devices to support and align joints may be very useful.

Sometimes, therapists use special machines to apply deep heat or electrical stimulation to reduce pain and improve joint mobility.

Occupational therapists can construct splints for your hand and wrist, and teach how to best protect and use your joints when they are affected by arthritis. They also show people how to cope better with daily tasks at work and at home, despite the limitations caused by rheumatoid arthritis.

Recommended frequent rest periods between activities, as well as 8 to 10 hours of sleep each night.

Support Groups

To find additional resources and information, see the section on support groups for arthritis.

Expectations (prognosis)

It should do blood tests or urine regularly to determine how well medications are working and whether they are causing any side effects.

Rheumatoid arthritis varies from person to person. People with rheumatoid factor, antinuclear antipeptidos cyclic citrullinated or subcutaneous nodules seem to have a more severe form of the disease. People who develop rheumatoid arthritis at an early age also appear to worsen more quickly.

Many people with rheumatoid arthritis are working full time. However, after many years, approximately 10% of patients with this type of arthritis to become severely disabled and unable to perform simple tasks of daily living such as washing, dressing and eating.

In the past the average life expectancy for a patient with this type of arthritis could be reduced from 3 to 7 years and those with severe forms of the disease often died 10 to 15 years earlier than expected. However, as we have improved the treatment for rheumatoid arthritis, severe disability and life-threatening complications have decreased significantly and in many people lead relatively normal lives.

Possible Complications

Rheumatoid arthritis is a disease that not only destroys joints, which can compromise nearly all organs.

Can present a potentially fatal complication in the joints when the cervical spine (neck bones) becomes unstable as a result of rheumatoid arthritis.

Rheumatoid vasculitis (inflammation of blood vessels) is a serious and potentially fatal complication of this type of arthritis that can lead to ulceration and skin infections present, bleeding gastric ulcers and neurological problems that cause pain, numbness or tingling. Vasculitis may also affect the brain, nerves and heart, which can cause stroke, heart attack and heart failure.

Rheumatoid arthritis can cause the exterior of the heart to become inflamed (pericarditis) and cause heart complications. Also may be inflammation of the heart muscle, called myocarditis, and both conditions can lead to the development of congestive heart failure.

Treatments for rheumatoid arthritis can also cause serious side effects. If you experience any of these effects, tell your doctor immediately.

When contacting a medical professional Back to top

Consult your doctor if you think you have symptoms of rheumatoid arthritis.

Prevention

There is no known prevention for rheumatoid arthritis. However, it is often possible to prevent major damage to the joints with proper treatment to onset of the disease.

Quit smoking. Research shows that the risk of developing rheumatoid arthritis is almost twice that for current smokers compared with nonsmokers.

Because rheumatoid arthritis may cause eye complications, patients must take regular checkups of your eyes.