Management Of Rheumatoid Arthritis And Gout

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Management of Rheumatoid Arthritis and Gout Stanley Osuagwu Florida International University Abstract Rheumatoid arthritis is a chronic inflammatory disease characterize by symmetric polyarthritis and joint changes including erythema, effusion and tenderness. Its course is characterize by remission and exacerbations. Rheumatoid arthritis can affect several organ, but usually involve synovial tissue changes in the freely movable joints like the wrist, the PIP joint, the metacarpophalangeal joints. This article provide a comprehensive review of the etiology, pathophysiology, epidemiology, clinical presentation, pharmacological therapy and the nursing implication. Introduction Rheumatoid arthritis is a chronic systemic…show more content…
Most evidence today support the concept that the pathology of rheumatoid arthritis has its bases in an inflammatory response involving the immune system. Other theory of causation include genetic factors, infectious agents and an antigen-antibody response. It is unlikely that a single factor is responsible for all cases of rheumatoid arthritis. Pathophysiology The main physiologic changes associated with rheumatoid arthritis include synovial membrane proliferation followed by erosion of the subarticular cartilage and subchondral bone. Although the exact etiology of RA is unknown, enormous evidence points to a series of immunologic events. Specific major histocompatibility complex (HMC) class 11 allele and human leukocyte antigen (HLA) are seen more frequently in patients with rheumatoid arthritis. The pathogenesis begins with stimulation of B and T lymphocyte and their proliferation which leads to activation of the blood vessel in the synovial membrane. As the synovial membrane enlarges lymphocyte and macrophages moves toward the area to phagocytize the invading antigen. Epidemiology The prevalence of rheumatoid arthritis in the U.S is now estimated to be 1.29 million people or 0.6 percent of the population. This figure show a reduction from the previous estimate of 2.1 million people. The prevalence and incidence of new cases per year appear to be decreasing since the 1960s. although there is a decline, rheumatoid arthritis appear in women twice as
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