topmedicaljournals.com – rheumatoid arthritis symptoms

Rheumatoid arthritis is a chronic systemic inflammatory disease primarily of the joints diartrodial. Including autoimmune disease with unknown etiology. Rheumatoid arthritis is characterized by inflammation of the membranes lining the joints (synovium) which causes pain, stiffness, warm, swollen and red. Inflammation of the synovium can invade and damage bone and cartilage. Tues inflammation causes release of enzymes that can digest bone and cartilage. So it can happen to lose shape and straightness in the joints, resulting in pain and reduced ability to move. Rheumatoid arthritis is more common in women, men and women with a ratio of 3:1. The comparison is reached 5:1 in women of childbearing age.

American Rheumatism Association criteria for Rheumatoid Arthritis, Revised 1987.

1. Morning stiffness, at least 1 hour
   2. Arthritis in at least three joints
   3. Arthritis of the wrist joint, metacarpophalanx (MCP) and Proximal Interphalanx (PIP)
   4. Symmetrical arthritis
   5. rheumatoid nodules
   6. Serum rheumatoid factor positive
   7. Specific radiological picture

For the diagnosis of RA, needed 4-7 criteria mentioned above. Criteria 1-4 must be at least sustained for 6 weeks.

DIAGNOSIS
Seronegative spondyloarthropathies, Sjogren’s syndrome

Examination support
• ESR, CRP
• serum rheumatoid factor, positive results observed in the majority of cases (85%), whereas a negative result does not rule out the presence of RA.
• Analysis of joint fluid. Can be seen an increasing number of leukocyte 2.000/mm3 above. This analysis once used to rule out the presence of crystal arthropathies
• Radiology hands and feet. Early picture of soft tissue swelling, followed by the juxta-articular osteoporosis and bone erosion on bare areas. Further narrowing of the gap state of visible joints, diffuse osteoporosis, erosion extends to the subchondral
• Biopsy of the synovium / rheumatoid nodules.

THERAPY
• Counseling
• Protection of joints, especially in the acute stage
• non-steroidal drugs antiinlamasi
• remitif Drug (DMARD)

• Glucocorticoids, minimum dose and the shortest possible time, to address the acute condition or a recurrence. Can be given prednisone at a dose of 20 mg doses and immediately tappering off
• When there is inflammation that is limited to 1-2 joints, Intra-articular steroid injection may be given as triamcinolon acetonide 10 mg or methylprednisolone 20-40 mg.
• Physiotherapy, occupational therapy, if necessary, can be given ortosis
• Surgery to correct the deformity

Rehabilitation is an action to restore the ability of RA patients by:

· Reduce pain

· To prevent joint stiffness and limited motion

· To prevent muscle atrophy and weakness

· Prevent the occurrence of deformities

· Increase the comfort and confidence

· Maintaining independence so as not to depend on others.

COMPLICATIONS
• joint deformity (boutonnierre, swan neck, ulnar deviation)
• carpal tunnel syndrome

CONCLUSION

Rheumatoid arthritis is a chronic systemic autoimmune disease that mainly occurs in the pathological process of the synovial fluid. Rheumatoid Arthritis Patients often present with significant arthritis and systemic signs of inflammation. Usually symptoms occur slowly as fatigue, fever, loss of appetite, weight loss, pain, and stiff joints. This disease is chronic and often recur, then the patient will experience a decrease in work productivity due to symptoms and complaints that arise cause physical activity, psychological, and quality of life suffers. Although the prognostic for the life of people with no harm, but difficult to cure disease is reached. The goal of treatment is to produce and maintain remission or as much as possible try to suppress the activity of the disease. The main objective of the program of therapy is to relieve pain and inflammation, preserve joint function and prevent and / or repair deformality.