Chronic inflammation of the connective tissue, in which joints are affected, is called rheumatoid arthritis. Symptoms, diagnosis, treatment of this disease will be discussed in the materials of this article.
What is rheumatoid arthritis?
This is a fairly serious disease, which in just a few years can turn an absolutely healthy person into a weak invalid. It is known that rheumatoid arthritis is classified as autoimmune ailments. It develops according to a simple scheme. Different types of white blood cells due to the influence of certain factors begin to rapidly destroy the tissues of their own joints. They swell, and after a while erosion appears. Tendons and ligaments are less affected. Cartilage itself is completely destroyed.
Pathology is characterized by chronic progressive inflammation of the synovial membrane of the joint. In most cases, this process extends to the feet, knees, joints of the hips and hands. As the disease progresses, the cartilage bone is affected, and the joints are deformed. In severe cases, systemic manifestations are possible with simultaneous damage to blood vessels, skin, muscles and heart.
History reference
Rheumatoid arthritis disease has been known since ancient times. Rheuma in Greek means "flow." There are several versions about the reasons for using this term. Some researchers believe that the disease was associated with the expiration of mucus, which gradually accumulated in the brain. Others explain his interpretation of the nature of the pain that occurs each time during an attack. Over time, it became clear that nothing and nowhere with arthritis does not flow, but they decided to keep the name.
This disease affects the safest parts of the human body - the bones. During archaeological excavations of the settlements, scientists found deformations characteristic of rheumatoid arthritis on the remains of skeletons. In medical directories you can find several names for this disease: chronic infectious rheumatism, deforming arthritis, disfiguring ailment, but this name has taken root.
The term “rheumatoid arthritis" was first proposed by A. Garro in 1858. However, a detailed description of the disease was laid out back in 1800 by Augustine Beauvais. He considered her one of the types of gout. In 1892, Garro introduced a clear distinction between the two.
Causes of Rheumatoid Arthritis
If you know the reasons why rheumatoid arthritis develops, diagnosis, treatment and prevention usually do not cause much difficulty. In addition, this information allows with a certain probability to prevent the further development of the disease. Its prevention, as a rule, is based on the elimination of the action of provoking factors.
The etiology of the disease is not fully understood. Experts have identified a number of factors that together can trigger the development of the disease. The main role belongs to hereditary predisposition. Normal white blood cells should kill foreign elements. These include bacteria, viruses, and cancer cells. If the body has a defect in the immune system at the genetic level, white blood cells gradually lose their ability to recognize “good” and “bad” elements. On the other hand, a change in the genes that are responsible for the work of certain types of white blood cells leads to a disruption in the ratio of cells. As a result, the inflammatory process starts, which does not stop in a timely manner and takes on a chronic form. Thus, rheumatoid arthritis gradually develops. Symptoms, diagnosis, treatment - these are several questions that every person who is at risk for this disease should know.
In close relatives, not the disease itself is transmitted, but the susceptibility of the immune system to the violation described above. It can be realized in the form of a disease. The likelihood of rheumatoid arthritis depends on the degree of relationship, as well as the impact of certain factors throughout life. The latter include:
- Smoking . The relationship between this addiction and arthritis, scientists noticed in the 70s of the last century. Smoking more than 25 cigarettes per day for a long period of time (more than 20 years) increases the risk of the disease. The components of tobacco smoke affect the cells of the immune system, as a result of which the latter begin to produce autoantibodies.
- Gender and age. It has been proven that the fair sex is more susceptible to rheumatoid arthritis. An ailment can manifest itself at any age, but most often this happens about 40-50 years.
- Infections A patient with rheumatoid arthritis may notice an exacerbation of pathology after a recent ARVI.
- Disorders of the hormonal background. Scientists have proven that taking oral contraceptives significantly reduces the incidence of rheumatoid arthritis. Pregnancy in women with this diagnosis often causes remission, and childbirth, on the contrary, contributes to exacerbation.
Under the influence of the described factors, cells of the immune system begin to attack the elements of the membranes of the joint, which provokes their inflammation. The skin in the affected area becomes hot and painful. The negative effect of cells of the immune system also spreads to the blood vessels, which explains the extra-articular manifestations of the disease.
Clinical picture
It is impossible to confuse classical rheumatoid arthritis with other pathologies of a similar nature. The first symptoms of the disease begin to appear within a few weeks, until inflammation becomes apparent. Initially, the disease affects the index and middle fingers. In this case, inflammation occurs and a slight swelling appears in the area of ​​the metacarpophalangeal joints. They are at the base of the fingers. A characteristic symptom of the disease is the simultaneous damage to the joints on the other hand. Pain can be observed from several months to one year. Such discomfort usually appears in the morning and lasts until noon, then goes into decline. After physical exertion or work, the pain syndrome goes away.
In parallel to the pathological process, small joints of the feet, which are located at the base of the fingers, join. Patients report soreness under the pads when pressed. As the disease progresses, larger joints become inflamed (ankle, shoulder and knee).
Other symptoms of the disease are rheumatoid nodules and morning stiffness syndrome. Patients note that after sleep a feeling of discomfort appears. The so-called rheumatoid nodules form in the area just below the elbow, on the feet and hands. In a section, they are represented by a collection of immune cells that surround a site of dead tissue.
In some patients, the clinical picture is supplemented by a deterioration in the general condition. The temperature rises, sleep and appetite disappear. Rheumatoid arthritis of the fingers at the advanced stage is characterized by deformation of the hands. This condition is accompanied by the so-called ulnar deviation, and the mobility of the joints gradually decreases. When vertebral joints join the inflammatory process, severe pains occur in the neck and neck.
Stages of the development of the disease
Several criteria are distinguished, thanks to which it is possible to accurately classify the stages of rheumatoid arthritis. The most informative ones are those that are based on the results of an x-ray.
They are usually divided into four categories:
- At the initial stage, the first signs of a decrease in bone density are distinguishable. This is the only manifestation of the disease, which can be determined by x-ray. Soft tissue gradually thickens. Sometimes on the bone you can distinguish light areas. These are the so-called cysts. If the joint spaces are narrow, we can talk about the rapid development of the disease and its imminent transition to the next stage. A distinctive feature of this stage of the disease is a prolonged course without obvious clinical signs. The patient may not notice health problems, so he is in no hurry to consult a doctor.
- The second stage is characterized by the further development of the pathological process and the involvement of bones in it. First of all, the hands in the area of ​​the elbows and wrists suffer. If erosion is localized near the cartilage, mobility is limited in this area. At the same time, the cartilage tissue itself may remain intact, but the muscles are already beginning to atrophy. Synovial bags swell and become slightly inflamed. During exacerbation, patients usually complain of aches and severe pain.
- With rheumatoid arthritis of the third stage, muscle atrophy and joint deformation are observed in the picture. If salt deposition is observed even at the initial stage of the development of the disease, then calcification is clearly distinguishable on x-rays.
- At the fourth stage, bone disorders become noticeable. On the x-ray, osteoporosis, multiple erosions and cysts are clearly visible. The joint is completely deformed, and the muscles around it are atrophied.
Determining the stage of rheumatoid arthritis allows you to choose the most effective therapy, as well as prevent possible complications.
Medical examination
Rheumatoid arthritis is classified as a chronic disease of unknown etiology, so its identification is often difficult. In 1997, the American College of Rheumatologists proposed several criteria for the diagnosis of this pathology, which remain relevant to this day. If four of the seven items from the list of symptoms are present, the diagnosis can be considered reliable.
- Morning stiffness.
- Rheumatoid nodules.
- The defeat of more than three joints.
- Positive rheumatoid factor.
- Damage to the wrist joints.
- X-ray changes.
- Symmetric damage to the joints.
Unfortunately, the above symptoms can be detected only in the late stages of the development of the disease. That is why if you experience morning stiffness and pain in the joints, you must go to the hospital. If rheumatoid arthritis is detected, the symptoms, diagnosis, treatment and preventive measures for this disease should be known to every doctor.
To confirm the final diagnosis, the patient is prescribed an x-ray of the hands and feet, a blood test to identify the rheumatoid factor and assess ESR. After the examination, the doctor selects the appropriate treatment. Usually it is complex and consists of several stages. We will talk about each specific option below.
Basic therapy
To eliminate the "basis of the disease" use the basic treatment of rheumatoid arthritis. The drugs prescribed by the doctor do not eliminate the pain and other symptoms of the disease. They are designed to interrupt the further development of the disease. The positive effect of the use of drugs becomes noticeable only after a month of treatment.
Gold preparations to combat this ailment have been used for about a hundred years. Their action is especially effective in the initial stages of the disease with severe joint pain and rheumatoid nodules. Possible side effects include the appearance of “golden” dermatitis and inflammation of the mucous membranes.
Immunosuppressants are also actively used in therapy (Methotrexate, Azathioprine). These rheumatoid arthritis drugs are aimed at artificially inhibiting the body's defenses. Due to the fact that they are borrowed from oncology, many are afraid to use them. However, this is a false fear. Lower doses are used to treat arthritis, so side effects are extremely rare.
In some cases, patients are prescribed sulfonamides. These are antibacterial drugs that inhibit the growth of pathogenic microflora. The likelihood of side effects is extremely small. Their effectiveness is slightly lower compared to immunosuppressants and gold preparations. Positive therapeutic dynamics in patients diagnosed with rheumatoid arthritis of the fingers is observed only after six months of such treatment.
Anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs) have an analgesic and antipyretic effect (Meloxicam, Diclofenac). They are prescribed for acute pain in the joints. These medications significantly improve the patient's condition. One has only to stop taking them, as the disease immediately returns. NSAIDs are not able to completely overcome the disease, they only eliminate unpleasant symptoms. Almost all medicines have contraindications, therefore, before starting a course of therapy, it is recommended to consult a doctor.
Selective drugs for rheumatoid arthritis have been used not so long ago. This is a new word in modern medical practice. Such drugs are designed to significantly reduce the number of side effects, since they act exclusively at the site of inflammation and do not affect other organ systems. Selective drugs selectively block the production of inflammatory substances in the cartilage of the joint. Medications are convenient to use. Of the possible disadvantages, it should be noted the effect on increasing blood coagulation. This, in turn, can cause a heart attack or stroke.
Also, corticosteroids (Prednisolone, Dexamethasone) are used to combat rheumatoid arthritis. These are hormonal drugs designed to reduce pain and morning stiffness in the joints. The attitude of doctors towards the use of corticosteroids is ambiguous. Some tend to use hormones to treat diseases, others are against it. The latter explain their opinion with a variety of side effects. Hormones, in addition to the general effect on the body, can increase blood sugar, lower immunity, and cause hypertension. That is why, before prescribing treatment, the doctor weighs all the pros and cons.
Topical treatment for rheumatoid arthritis
The drugs described above are not suitable for all patients. Some have individual intolerance to the constituent components, others do not observe a positive therapeutic effect. Therefore, in some cases, doctors resort to local treatment.
In the chronic course of the disease, laser irradiation is used. Such therapy gives a mild anti-inflammatory effect. Approximately 80% of patients report improvement in general condition.
Another treatment option is cryotherapy. During the procedure, the specialist acts by deep cooling on the affected joints. Cryotherapy is absolutely harmless and has no contraindications.
The use of ointments and various creams gives only temporary relief. The thing is that the skin pass no more than 7% of the active substances. This is not enough to obtain a lasting therapeutic effect. Despite the wide range of benefits of treatment with ointments, they resort to their help in exceptional cases.
Physiotherapy
After removing the acute form of the disease, massage can be used, as well as other methods of physiotherapy. The thing is that such treatment has a stimulating effect and helps to reduce local inflammation. These methods of treatment improve blood supply to the affected joints and at the same time increase their mobility. In medical practice, paraffin, UHF, phonophoresis, as well as infrared radiation are actively used today.
Proper nutrition
A strict diet is indicated for patients diagnosed with rheumatoid arthritis. Symptoms, diagnosis and the course of this disease can determine its cause. However, regardless of these factors, dietary adjustment is offered to all patients.
Doctors believe that some products contribute to the development of inflammatory processes in the tissues. These include pork, all citrus fruits, wheat and rye, dairy products, and corn. Doctors recommend eating more fish, pearl barley and buckwheat, chicken eggs. A special place in the diet should belong to fruits and vegetables rich in vitamins. For the entire course of therapy, it is recommended to exclude fatty and fried foods. Products should be steamed, and often eat in small portions. Together with drug therapy, a change in the usual diet has a positive effect on the dynamics of recovery.
Juvenile rheumatoid arthritis
Symptoms, treatment, diagnosis in children of this disease practically do not differ from the course and therapy in adult patients. Juvenile rheumatoid arthritis is characterized by rapid development. For 100 thousand children, this disease occurs in every 15 patients.
The disease occurs mainly up to 16 years and can last for several years. Its development is usually the result of various effects, ranging from viral infections and ending with increased sensitivity to certain environmental factors.
The main symptom of rheumatoid arthritis in children is pain in one or more joints. On examination, their deformation is observed, which initially manifests itself in the form of swelling. Gradually, the functionality of the joints decreases. In some cases, in small patients, the lymph nodes increase, the temperature rises.
Therapy includes the use of NSAIDs (Ortofen, Brufen) in combination with gold salts and immunosuppressants. With the inactive stage of the disease, children are recommended to receive spa treatment, where with the help of various recreational measures it is possible to normalize physical activity.
Juvenile rheumatoid arthritis should not be ignored. Symptoms, treatment, diagnosis of this disease in young patients require a qualified approach. If timely take all the necessary therapeutic measures to eliminate this ailment, you can avoid the development of serious complications. In addition, high-quality treatment in the initial stages does not affect the future life of a small patient.
Prevention
Many patients are interested in how to cure rheumatoid arthritis. The diagnosis sounds intimidating, but you should not be afraid of it. Unfortunately, there is no cure for this disease. This is a chronic process that often requires lifelong therapy. The most important thing is to start it immediately.
Today, specialists from all over the world are in constant search for new therapeutic methods that are not accompanied by side effects. This issue is especially important for women in a position suffering from rheumatoid arthritis. Indeed, in this case, the intake of many drugs is prohibited.
Many will agree that the best treatment for any ailment is its timely prevention. To ensure joint protection, doctors recommend a healthy lifestyle. It is understood as the exclusion of all bad habits, a balanced diet, sufficient physical activity. Not the last role belongs to the strengthening of immunity and the fight against overweight.
Now you know what signs rheumatoid arthritis is associated with. Symptoms, diagnosis, treatment of the disease - these are several interrelated issues that require an exclusively qualified approach. Rheumatoid arthritis is classified as an ailment with a poor prognosis. If you take all the measures to eliminate the inflammatory process in a timely manner, strictly follow the doctor's recommendations, you can translate the pathology into a chronic form.