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Rheumatoid Arthritis Symptoms
Rheumatoid Arthritis : Symptoms And Treatment
Rheumatoid arthritis (RA) is a chronic multi-system disease characterized by synovial inflammation and infiltration by white blood cells principally involving the peripheral joints in a
The cause of the disease is unknown. It affects more commonly women in their fourth or fifth decade. White people are at greater risk of developing the disease. There is definite familial predisposition. The disease is thought to be an autoimmune disease as a result of which our own immune system acts against the normal cells of our body and causes damage.
Usually it is a slow onset chronic disease involving several joints in a symmetric manner. In some cases, joint involvement is asymmetric; initially involving one or two joints then progressing to involve other joints- confused with gout. In a small number of patients, the disease may arise suddenly within few days to weeks.
The disease is characterized by symmetric involvement of certain joints- fingers, wrist, knee, feet, ankles, upper cervical spine. In the joints of hand, proximal interphalangeal joints and metatarsophalangeal joints are affected but distal interphalangeal joints are spared. Pain in the joints is aggravated by movement. Joints become stiff after periods of inactivity evident as morning stiffness and persist for more than an hour. The joints are swollen, warm and tender and limitation of movement is also present.
Other symptoms like weakness, easy fatigability, weight loss, anorexia, low-grade fever are usually present. In long standing cases, fibrosis and contractures develop that lead to fixed deformities. Common deformities of hand that occur in RA are 'Z'-deformity, Boutonniere deformity and swan-neck deformity. One can also notice rheumatoid nodules under the skin around the joints, commonly around the elbow, extensor aspect of forearm and Achilles tendon. There is weakness and atrophy of muscles.
Involvement of blood vessels is seen in severe disease in the form of inflammation and called vasculitis. This leads to damage to nerves as polyneuropathy, skin ulcerations, gangrene of fingers and toes and internal
The course of the disease is variable and it is difficult to predict the outcome. Rarely, elderly above 60 years may also suffer from the disease and in them the prognosis is poorer.
Investigations-
Presence of serum Rheumatoid factor and anti-CCP antibodies are very much specific for rheumatoid arthritis. Erythrocyte Sedimentation Rate (ESR) is also raised but it is not specific. Hemoglobin may also be reduced due to anemia.
X-ray imaging and MRI are also helpful in assessing joint damage. MRI has the advantage of detecting early disease which may not be evident in the X-ray image.
Diagnosis is done according to the criteria set by the American College of Rheumatology.
Treatment-
Rest and splinting of the affected joints reduces mobility and helps reducing pain. Exercises for maintaining muscle strength and joint mobility should be advised. Orthotics and assistive devices may also be prescribed for this purpose. Counseling the patients and their family is also an important aspect.
Non-Steroidal anti inflammatory drugs (NSAIDs) are the first drugs prescribed as they provide rapid pain relief. Low dose glucocorticoids are advised to reduce inflammation in the joints. Though NSAIDs and glucocorticoids are very effective in providing symptomatic relief but they are not effective in preventing progression of disease. Disease Modifying Anti Rheumatic Drugs (DMARDs) are the drugs that are effective in reducing or preventing progression of the disease process. Drugs included in this category are Metotrexate, Hydroxychloroquine and Sulfasalazine. These drugs take 6-8 weeks time to act, and for that period NSAIDs and glucocorticoids are prescribed.
By Dev Senapati - I am a college student studying in India.I am here to express myself through my writings.I will be completing my bachelor degree next year.
I have MS, am now presenting rheumatoid arthritis symptoms but only on the left side, is this MS too?
Diagnosed with MS 13 yr. ago. Nearly blind now, permanent numbness in left arm. I saw a podiatrist for swelling (egg size) on top of foot, x-rays show joints have fused in that area and by big toe. Right foot is fine, right side of body is fine. Unsure of whether I should continue with podiatrist.
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