Arthritis (Rheumatoid)

WHAT IS ARTHRITIS (RHEUMATOID)? 

Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just the joints. The condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels.

Causes 

• Rheumatoid arthritis occurs when the immune system attacks the synovium, the lining of the membranes that surround your joints.

• The resulting inflammation thickens the synovium, which can destroy the cartilage and bone within the joint.

• The tendons and ligaments holding the joint together weaken and stretch resulting in the joint losing its shape and alignment.

• Genes may not actually cause rheumatoid arthritis, but they can make one more susceptible to infection that may trigger the disease.

WHAT ARE THE SYMPTOMS OF RHEUMATOID ARTHRITIS? 

• Tender, warm, swollen joints

• Joint stiffness worse in the mornings and after inactivity

• Fatigue, fever, loss of appetite

• Early rheumatoid arthritis tends to affect particularly the joints that attach fingers to hands and toes to the feet. Symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders and most often occur in the same joints on both sides of the body.

• It can affect many non-joint structures like skin, eyes, lungs, heart, kidneys, salivary glands,nerve tissue, bone marrow, blood vessels, etc.

•  Over time, rheumatoid arthritis can cause joints to deform and shift out of place.

DIAGNOSIS AND TREATMENT

Diagnosis: Diagnosis of rheumatoid arthritis can be arrived at by:  

• Physical review of joints for swelling, redness,warmth, reflexes and muscle strength.

• Blood Tests to determine elevated erythrocyte sedimentation rate, C-reactive protein, anti-cyclic citrullinated peptide (anti-CCP) antibodies

• Imaging tests (X-rays,MRI, Ultrasound, etc) to gauge the severity of disease 

Treatment 

• Medications Clinical studies indicate that remission of symptoms more likely when treatment begins early with medications known as disease-modifying antirheumatic drugs (DMARDs) or  Nonsteroidal anti-inflammatory drugs (NSAIDs). Side effects vary but liver damage, bone marrow suppression and severe lung infections not ruled out.

• Physical or occupational therapy to help keeping your joints flexible. 

• Assistive devices and appliances can make it easier to avoid stressing your painful joints. 

• Surgery to repair damaged joints if medications fail to prevent or slow joint damage like, Synovectomy, Tendon repair, Joint fusion, Total joint replacement.

IMPORTANT INFORMATION

1. Risk factors of Rheumatoid Arthritis are: 

• Gender Women more likely than men to develop rheumatoid arthritis.

• Age. Commonly begins in the middle age.

• Family history . Increases risk 

• Smoking leasds to greater disease severity.

• Environmental exposures to as asbestos or silica dust 

• Obesity. Obese are at a higher risk

2. Complications: Rheumatoid arthritis increases risk of developing:

• Osteoporosis

• Rheumatoid nodules ( firm bumps of tissue) 

• Dry eyes and mouth (Sjogren's syndrome) 

• Infections

• Abnormal body composition 

• Carpal Tunnel Syndrome

• Heart problems

• Lung disease

• Lymphoma (blood cancer) 

3. Preventive measures include, exercise, applying heat and cold to affected part, reducing stress, deep breathing and muscle relaxation and diet in consultation with the treating Doctor