What is rheumatoid arthritis: general information about the disease
Rheumatoid arthritis is an autoimmune disease of unknown etiology characterized by a symmetrical lesion of cartilage and bone tissue. The disease is often accompanied by the development of a wide range of systemic manifestations. In most cases, rheumatoid arthritis has a chronic course and without timely treatment leads to deformity and dysfunction of the joints, deterioration of quality of life, disability and premature death.
The disease can occur at any age and is more common among women. Most often, the disease affects the hands, fingers, knees, feet, elbows.
Rheumatoid arthritis: causes and factors of development
The exact cause of the disease is unknown. It is known that in autoimmune diseases, which include rheumatoid arthritis, the immune system perceives healthy tissues as foreign agents and fights with its own body.
In addition, the role of a wide range of infectious and non-infectious factors that can indirectly participate in the development of rheumatoid arthritis in the context of genetic susceptibility is being studied. These factors include: Epstein – Barr virus, parvovirus B19, retroviruses, antigens and bacteria stress proteins, smoking, coal dust, medicinal substances, some components of mineral oils, various chemical compounds.
Types of disease: classification of rheumatoid arthritis
It is customary to distinguish the following forms of the disease:
- Juvenile – rheumatoid arthritis, developing in children up to 16 years of age. Often with age, the severity of this pathology fades away, but the disease does not disappear completely.
- Seropositive – a form of rheumatoid arthritis, in which the rheumatoid factor is present and can be identified using analyzes.
- Seronegative – a form of rheumatoid arthritis, in which rheumatoid factor is not detected in the joint fluid.
- Rheumatoid arthritis of the elderly – age-related form of rheumatoid arthritis, developing in old age in both women and men.
Separately isolated undifferentiated arthritis. This condition is not fully understood and may be the initial stage of rheumatoid arthritis.
Doctors classify rheumatoid arthritis and, depending on the picture observed during X-ray examination. According to this parameter, rheumatoid arthritis is divided into four categories:
- First stage. In this case, the first signs of bone thinning are noticeable. In the overwhelming majority of cases, this is the only change that can be seen on an X-ray image at the initial stage of rheumatoid arthritis. It is noteworthy that this stage of rheumatoid arthritis can develop at any age, and it can proceed for a very long time without showing itself.
- Second phase – bone erosion begins to develop. Most often at this stage the joints of the elbows and wrists are affected. If the erosive process is located in the area of the cartilage of the joint, then the patient has limited mobility. At the same time, the cartilage tissue itself is not deformed, but the muscles surrounding the diseased joint gradually begin to atrophy. At this stage, marked inflammation and swelling of synovial bags. With exacerbation of the disease, the joints may be hot, and patients complain of aches and pains. With the progression of the erosive process in the joint, the third stage approaches, which is clearly visible on the X-ray image.
- Third stage – X-ray shows not only the thinning of the bone and erosion, but also muscle atrophy, which becomes extensive. In this case, the joint itself is deformed. If at the first stage the process of salt deposition was started, then at the third stage the calcification becomes noticeable on the X-ray.
- Fourth stage – X-ray fixes erosion, cysts, serious violations in the bones. The joint is completely deformed, and the muscles located around it are atrophied. At this stage, the disease affects all the limbs, and patients complain of severe, incessant pain.
Symptoms of rheumatoid arthritis: how the disease manifests itself
The primary symptoms include fatigue, weakness, a slight fever, loss of appetite, inflammation of the salivary glands. Later, pain and discomfort appear in the joints, which are characterized by:
- Lasting stiffness in the morning. Joints can be painful, hot, swollen.
- Usually symmetrical joint pain.
Most often affected are fingers, hands, shoulders, elbows, hip joints, knees, toes, ankles, joints of the lower jaw and cervical spine.
Over time, the movement of the joints becomes limited, they are deformed.
Other symptoms of the disease:
- chest pain while breathing
- itching and burning in the eyes
- appearance of nodules under the skin
- numbness, tingling, or burning in the limbs.
Damage to the joints may manifest itself 1-2 years after the onset of the primary symptoms.
After the diagnosis of the disease, the patient needs to ease the workload and limit activity during the exacerbation. At the same time, patients with rheumatoid arthritis need to perform stretching exercises and aerobic exercises.
Diagnosis is based on the assessment of the clinical picture, the results of laboratory tests and x-rays of the joints.
A specific blood test for the diagnosis of rheumatoid arthritis – anti-CCP.
Other studies include: complete blood count, C-reactive protein, ESR, ultrasound and MRI of the joints, x-rays of the joints, rheumatoid factor, analysis of synovial fluid.
The effectiveness of treatment is assessed using blood and urine studies over time.
The treatment of the disease is usually lifelong and includes medication, physical therapy, physical therapy. If necessary, surgical treatment is possible. The time of active treatment can delay the destruction of the joints for a long time.
Of the medications, glucocorticosteroids (diprospan et al), immunosuppressive drugs, nonsteroidal anti-inflammatory drugs such as meloxicam, antimalarials, corticosteroids, and drugs are used. possessing enzymatic activity and improving the rheological properties of blood (wobenzym, etc.), biological therapy.
For serious lesions of the joints, surgical treatment is required (synovectomy or total joint replacement).
Therapeutic physical training and physiotherapy includes specially selected exercises, a magnet, an electromyresis, and ultraphonophoresis.
Rheumatoid Arthritis Complications
The inflammatory process can spread to other organs and lead to anemia, lung damage, instability of the cervical spine and spinal cord injuries, diseases of the salivary glands. Rheumatoid vasculitis can cause ulcers on the skin, cause gastric bleeding, and lead to a heart attack or stroke.
Pericarditis and myocarditis can lead to heart failure.
Prevention of rheumatoid arthritis
To date, methods of preventing rheumatoid arthritis does not exist. At the same time, timely treatment is the prevention of joint damage.
The following measures can also be attributed to non-specific measures for the prevention of rheumatoid arthritis:
- The early elimination of inflammatory foci in the body. Keep in mind that chronic inflammation is a constant stress for the immune system. Timely treatment of angina, tonsillitis, caries, sinusitis and other inflammatory diseases will prevent the onset of serious pathologies, including rheumatoid arthritis.
- Avoiding hypothermia. Dress warmly and avoid sudden changes in temperature, since under such conditions the body’s defenses drastically fall and inflammation develops.
- Refusal of bad habits, in particular, from smoking and excessive use of alcoholic beverages.
- Treatment of viral infectious diseases under the strict supervision of a physician.
- Adequate provision of the body with vitamins and minerals, especially during periods of vitamin-mineral deficiency (in winter and early spring).