Pathophysiology:
Rheumatoid is a Chronic inflammatory disease , which is an inflammation in synovial tissues lining of joints causing proliferations and erodes cartilage & bones surface .the surrounding tendons and muscles that stabilize the joints will become weak and lose its function , leading to joints damage
It occurs when the immune system start to attack its own body against the membrane lining joints, sometimes Hormonal and environmental factors can act as triggers .
It occurs in women more than males and age of onset reaches its peak in the fourth decades.
Rheumatoid affects mainly the wrist and fingers and sometimes the other parts of the body like neck , knee, hips , ankle .. etc
If it occurs for example in one knee or hand
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Rheumatoid characterized by joint involvement and extra-articular manifestations some are commen and some are not
Diagnostic tests : There is no specific single diagnostic test , there is combination of the display of the joint involved ; depend of clinical presentation : clinical, laboratory, and imaging features. o Laboratory tests ( Routine examination) :
1- ESR ( Erythrocyte Sedimentation Rate “sed rate” ) : usually high This test is normal blood test which a sample of blood is drawn from the vein using a sterilized needle, then The blood is amassed in a sample test tube which is then sent to be tested in lab . It take few minutes . and if the test result is higher than normal may be associated with an autoimmune disorder, such as Rheumatoid arthritis . (link )
2- CRP ( C-reactive protein test) ) : usually high
Test of the level of C-reactive protein in the bloodstream that indicates general levels of inflammation in the body. , a normal CRP level is less than 10 milligrams per
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2- Magnetic resonance imaging (MRI) : mainly cervical spine
3- Ultrasonography of joints
. (William .C. (2017 ) , (( Howard. R. (2015)) [R2]
Treatment : . DMARDS (Disease-modifying Antirheumatic Drugs ) is the Optimal treatment for people who suffered from RA . it can be classified as : Drugs that can repression the disease pathway like :
4- Gold : it could be a treat but it has many severe negative effects for 5% of patient
5- Penicillamine: agent that’s similar to the ation of gold used to treat many cases , usually the rate of its onset is slow .
6- Sulfasalazine: agent that’s similar to the ation of gold , to treat failed RA in responding to (NSAIDs) .
And also drugs that can affect the immune process like :
7- Chloroquine and hydroxychloroquine: it is an antimalarial agent to treatment RA, it’s usually better than gold or penicillamine.
8- Methotrexate: in the UK it classified to be the most common agent for the early treatment of (RA ) .
Azathioprine , Ciclosporin, Leflunomide and others are also examples of drugs that can help in Rheumatoid Arthritis treatment. (Laurence .K.(2014)(link)
"Rheumatoid joint inflammation is an interminable infection set apart by irritation of the joints, frequently influencing the hand joints and both sides of the body in the meantime" (Royal Australian College of General Practitioners, 2009).
Anti-CCP antibodies: This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP) (3). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop (4). When used with the RF, this test’s results are very useful in confirming a rheumatoid arthritis diagnosis (3).
Rheumatoid arthritis (RA) is a chronic, progressive autoimmune disease that is systemic in nature but primarily targets and damages the synovial joints. It is characterized by painful, swollen, stiff joints, which manifest primarily in the hands, wrists, elbows, knees, ankles, and feet. RA is more common among women than men and increases in prevalence with age, however it can also occur in young adults and children (Lee & Weinblatt, 2001).
It is very important to know how to cope with and manage symptoms of RA. For example, my family member who went through the experiences of RA, and developed depression when she found out she has to take multiple medications, which had dangerous symptoms. She has gotten better over time, but that is only with the help and support of family and close friends. One way to manage the symptoms of RA was continuing to do things she enjoyed. In other words, the symptoms of RA cause stress and it is important that patients stay mentally positive. By doing activities a person loves, people will “feel good,” and be optimistic about life, and managing the symptoms of RA. Therefore, it is important to have the support of family and friends when dealing Rheumatoid Arthritis
Rheumatoid arthritis cannot be cured, but there are treatments that help ease the symptoms, and help one cope with the disease. For example, a study on Tai chi has shown relief in rheumatoid arthritis patients (Uhlig 2010). Tai Chi program consists of improving muscle strength, balance, muscle tone, flexibility and mobility to the body. Therefore, doing exercise movements that are low in intensity, and not cause stress to the body. For example, stretches of muscles, extension, and flexion of knees, head, and neck (Uhlig 2010). Another treatment available is acupuncture which is part of the Chinese medicine. Acupuncture has shown to manipulate the pain by boosting natural pain killers in the body called endorphins ( Ratini 2015) Treatment and follow-up appointments are very important to help with the disease, and see if adjustments or changes need to make (Ruderman and Tambar 2010). Living with rheumatoid arthritis is possible with the right treatments and positive
Rheumatoid Arthritis is an inflammatory disease of unknown etiology with an autoimmune pathogenesis; it has the characteristics by arthropathy with severe bone deforming and systemic manifestations (Negrie, et
Signs and symptoms of rheumatoid arthritis may include joint pain, tenderness, swelling or stiffness for six weeks or longer, morning stiffness for 30 minutes or longer, firm bumps of tissue under the skin on the arms (rheumatoid nodules), fatigue, loss of appetite and a low-grade fever. Early rheumatoid arthritis tends to affect smaller joints symmetrically first such as the wrist, certain joints of the hands, and feet. As the disease progresses, symptoms often spread to the knees, ankles, elbows, hips and shoulders. Symptoms may flare (periods of increased disease activity) lasting for days or months. It is difficult to diagnose RA in its early stages because the signs and symptoms resemble other inflammatory diseases. No single test can confirm RA. The rheumatologist will ask questions about personal and family medical history as well as recent and current symptoms (pain, tenderness, stiffness, difficulty moving.) During the physical exam, the doctor will examine each joint, looking for tenderness, swelling, warmth and painful or limited movement. Blood tests will measure erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels. Although not specific to RA, these levels indicate the presence of an inflammatory process in the body. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) are antibodies found in a large number of people with RA. An X-ray, ultrasound or magnetic resonance imaging scan may be recommended to look for joint
Rheumatoid Arthritis or (RA) is an autoimmune disease that attacks the joints and connective tissue. The result is inflammation that produces permanent damage in the joints. Rheumatoid arthritis is a chronic syndrome that tends to be progressive and destructive as compared to Osteoarthritis or (OA), which is more of an age related disease caused by “wear and tear” of the joints. In contrast to (OA), rheumatoid arthritis is characterized by inflammation mostly of the joints, but is a general body disease.
Rheumatoid Arthritis (RA) is a systemic inflammatory autoimmune disease associated with swelling and pain in multiple joints. First joint tissue to be affected is the synovial membrane, which lines joint cavity. Multiple immune-regulatory cytokines (such as B-cells and interleukins) contribute to joint damage. Eventually, inflammation may spread to articular cartilage, fibrous joint capsule, and surrounding ligaments and tendons, causing pain, joint deformity, and loss of function.
Rheumatoid Arthritis is an inflammatory disease that affects the small joints in your hands and feet. It affects the lining of your joints causing pain and swelling. Which can eventually cause bone erosion and joint deformity? An autoimmune disorder, rheumatoid arthritis occurs when your immune system attacks its own body tissue. This disease can occur at any age but usually between the age of 40 and 60 years of age. Rheumatoid arthritis usually attacks your smaller joints first, such as those that attach your fingers to your hands, and your toes to your feet. As the disease progresses, symptoms sometimes spread to the wrists, knees, ankles, elbows, hips and shoulders. Over time it can cause your joints to deform and shift out of place.(National
Since rheumatoid arthritis is a systemic disease, it can also affect other organs and tissues, but it primarily attacks the joints in a symmetrical fashion. Rheumatoid arthritis develops from an abnormal immune response caused by exposure to an antigen, in a patient that is genetically susceptible. Autoantibodies develop and attack the patient’s cartilage and synovial tissues once the antigen exposure has occurred (Nelson, 2011). One of the most common
Rheumatoid Arthritis, which is abbreviated as (RA), by definition, is an inflammatory immune-mediated defect. In developed countries, its prevalence is about 0.5 to 1%. It is a serious disease whose effects can at times lead to permanent disability. Some of the effects include bone erosion, articular destruction and chronic synovial inflammation, which results in functional decline and disability. The Introduction of effective and efficient intervention has been put in place to reduce joint damage and functional impairment.
improvements have been made in its treatment compared to historical therapies. Patients exhibit similar but varying
Rheumatoid arthritis (RA) is a disease that is described as “systematic inflammatory disease that manifests itself in multiple joints in the body”. (Center for Disease Control, 22 Jul. 2016) It is an autoimmune disease that affects millions in the US both directly and indirectly. RA affects both genders and is prevalent in people of all races and nationalities. Symptoms for RA include swollen or stiffness in joints, fatigue, and fever. (Mayo Clinic Staff, 18 Mar. 2016) Treatment for RA ranges from corticosteroids, to non-steroidal anti-inflammatory drugs (NSAIDs), to an aggressive treatment with non-biological disease-modifying antiheumatic drugs (DMARDs) (Arthritis Foundation National Office, Web. 5 Sep. 2016) Therapy with a physical or occupational therapist could assist with reducing inflammation and even pain through exercise motions, and provide relief in completing daily tasks. (Mayo Clinic Staff, 18 Mar. 2016).
The goal of most medications used to treat the disease is to decrease pain, heat and swelling in the affected joint(s).