Rheumatoid arthritis is a chronic inflammatory process primarily in the connective tissues of the joints. The disease can affect other organs if timely measures are not taken to treat it.
Damage to the joints begins with inflammation of the synovium (the inner layer of the joint capsule). As the disease progresses, bone erosion and deformation may occur.
Arthritis occurs in 2% of the population and is 3 times more common in women than in men. The development of the disease occurs mainly at 30–50 years of age. The disease is rarely diagnosed in children with weakened immune systems.
If treatment measures are not taken, complications may occur in the form of:
diseases of the cardiovascular system;
disturbances in the functioning of the nervous system;
damage to the kidneys, lungs, etc.
Classification of rheumatoid arthritis
Based on the duration of the disease, there are 4 stages:
early (up to 6 months);
progressive (from 6 to 12–18 months);
final (from 18 to 24 months);
terminal (more than 24 months).
initial stage
This period is characterized by primary minimal damage to the synovial bursae, which is accompanied by the appearance of mild pain and swelling of the periarticular tissues. There may be slight thinning of the bone tissue.
Second stage
The disease begins to progress. The synovial membrane thickens. X-rays show bone changes. Stiffness in movements and painful sensations in some positions appear.
Third stage
A long-term inflammatory process leads to the destruction of cartilage and bone tissue. The functions of the joints are impaired. Severe pain appears. The symptoms of the disease are pronounced.
Terminal stage
At this stage, irreversible changes occur in the joints. Their mobility may be lost. The person becomes disabled.
Causes
The causes of arthritis are not fully understood. Doctors identify quite a few predisposing factors for the onset of the disease.
Basic
More than 10 factors can trigger the development of arthritis.
These include:
hereditary predisposition;
past infectious diseases such as herpes, rubella, hepatitis B, etc.;
injuries received;
surgical operations;
smoking;
large body weight;
stressful situations;
constant contact with mineral oils (some substances in them can cause inflammation of the joints);
low levels of sex hormones;
allergies;
severe hypothermia;
work in damp areas, etc.
Who's at risk
The risk group includes people who have had infectious diseases, as well as those with allergic diseases and disorders of the hormonal system. Patients who have undergone surgery due to injuries.
Several professions can be considered at risk:
mechanics and turners in factories, auto mechanics in auto repair shops who process metal products and come into contact with engine oils;
fish farmers working in wet fish-growing workshops;
builders who work outside at any time of the year and can get colds in their joints.
Localization of the process - what else can hurt
With the disease, inflammatory processes may develop in other organs and tissues of the body, which lead to:
to thinning and dry skin, the appearance of subcutaneous formations - rheumatoid nodules with a diameter of up to 20 mm;
to disruption of the gastrointestinal tract, which is accompanied by decreased appetite, pain and heaviness in the stomach, flatulence;
to damage to the pleura in the lungs, this can cause exudative pleurisy;
to diseases of the heart and blood vessels;
to disruptions in the functioning of the urinary system;
to damage to the nervous system, which manifests itself in the form of impaired sensitivity, thermoregulation, and paralysis.
Symptoms of the disease
Rheumatoid arthritis develops gradually. There is even a prodromal period, the formation of which occurs several weeks and months before the development of the disease. A person may experience weakness, malaise, muscle pain, and the temperature rises to 37.1–38°C.
The severity of the clinical picture of the disease depends on the severity of the disease, the presence of complications, and the location of the pathology.
Initial
At the initial stage, the following symptoms appear:
morning stiffness, which can last up to several hours;
febrile fever (temperature 38-39°C);
enlarged lymph nodes;
hepatosplenomegaly;
muscle pain.
Main manifestations
With arthritis, signs of general intoxication of the body appear (weakness, headache , fever).
The joints are affected, first in small ones (hands, toes), then in large ones (knees, shoulders). Painful sensations appear when moving. Gradually, the joints lose their functions and become immobilized. Their deformation is observed. This is accompanied by severe muscle atrophy.
During the disease, the nature of tissue damage may vary. In some cases, signs of inflammation predominate, in others, proliferation occurs (overgrowth of connective tissue and deformation).
Often, dense painful formations - rheumatoid nodules - form under the skin, and vasculitis (inflammation of blood vessels) can develop.
An X-ray examination reveals pathological changes in the joints.
Pain intensity
Rheumatic pain is divided into acute, characteristic of the initial stage of the inflammatory process, and chronic, with tissue destruction and changes in bones, cartilage, and soft tissues.
Patients report the following types of pain:
acute, similar to an electric shock (51–52%);
tingling (52–53%);
burning sensation (24–25%);
painful sensation of cold (33–34%);
unpleasant crawling (34–35%).
Often the pain is mixed. Its intensification indicates an exacerbation of the disease.
When to see a doctor
You should consult a doctor when the first signs of illness appear. In the early stages it is easier to treat.
A visit to the doctor should be scheduled in the following cases:
the appearance of mild pain in the joints, mild stiffness in the morning;
presence of the disease in close relatives;
if you have suffered a severe infectious disease;
in case of severe hypothermia;
with daily feelings of weakness and malaise.
Diagnostic methods in Kyiv
In Kyiv, you can contact the medical diagnostic center “Meddiagnostika”, where specialists identify the disease in the early stages. The medical institution has extensive experience in diagnosing and treating the musculoskeletal system (more than 42 years). Experienced doctors will select a medication regimen and offer physiotherapy, which can be obtained directly at the center.
You can also contact local clinics or private medical organizations.
Diagnostics involves:
Laboratory research. Blood and synovial fluid are used as research material. A clinical blood test is characterized by an increase in the number of leukocytes, anemia and a high ESR. Biochemical examination reveals rheumatoid factor and antibodies to cyclic citrullinated peptide. C-reactive protein increases, and sometimes antistreptolysin-O is elevated.
Instrumental diagnostics. The attending physician may prescribe x-ray , ultrasound , MRI of joints , arthroscopy, and refer for a diagnostic puncture of the joint.
Equipment of the Center for diagnostics
MRI machine 1.5 T
Ultrasound machine Philips AFFINITY 50
X-ray complex “Radspeed” SHIMADZU
Ultrasound machine GE LOGIQ F8
How to quickly relieve pain
To quickly relieve pain, take non-steroidal anti-inflammatory drugs.
With high activity of the inflammatory process, intense pain, and systemic manifestations of arthritis, doctors prescribe glucocorticosteroids.
Take medications only as prescribed by a doctor.
Non-surgical treatment of rheumatoid arthritis
Treatment of the disease includes 2 stages: relieving exacerbation and maintenance therapy.
In the first, the main goal is to reduce severe pain, reduce swelling and inflammation. The patient is prescribed non-steroidal anti-inflammatory drugs and glucosteroids. The first relieve acute pain and inflammation. The second are hormonal drugs that have anti-inflammatory and immunosuppressive effects.
Non-surgical treatment methods include:
Pulse therapy. A method involving the administration of large doses of drugs in a hospital under the supervision of a physician.
Biological therapy. The goal is to uncouple the pathogenetic chain that contributes to the occurrence of the inflammatory response. The method involves the introduction of genetically engineered biological drugs (proteins of the immunoglobulin group).
Local treatment. The method involves targeted action on the tissues around the affected joint by rubbing in medicinal ointments and creams.
Physiotherapy. The method involves the use of ultrasound, galvanic currents, ozokerite and paraffin applications, and infrared irradiation. Its goal is to eliminate morning stiffness and increase physical activity.
Massage. It alleviates the patient's condition, helps eliminate pain and improve joint mobility.
Acupuncture. The purpose of the procedure is to influence biologically active points in order to launch natural metabolic processes and improve microcirculation.
Physiotherapy. The set of exercises includes simple movements that do not overload the joints. When performed, mobility improves.
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