Rheumatoid Arthritis, Symptoms, Diagnosis and Treatment
gastropathy rheumatoid arthritis - a systemic disease of connective tissue, mainly affecting small joints of the type of erosive and destructive polyarthritis of unknown etiology with a complex autoimmune pathogenesis.Causes of the disease on this day are unknown. Distinguish "joint damage" and "joints exception." Rheumatoid arthritis is often combined with other joint diseases - osteoarthritis, rheumatism, systemic connective tissue diseases.Allocate the following options for the clinical course of rheumatoid arthritis:The classic version of the (symmetric defeat both small and large jointsMono-or oligoarthritis, mainly affecting the large joints, most often the knee. Severe disease onset and reversibility of all manifestations during 1-1,5 months (arthralgias are migratory in nature, radiographic changes are absent, anti-inflammatory drugs offer relatively positive effect in the latter there are all the symptoms of rheumatoid arthritis).DiagnosisDiagnosis of rheumatoid arthritis (RA) - For a long time there was no specific test that would unambiguously confirm the presence of the disease. Currently, diagnosis of disease based on biochemical analysis of blood, changes in the joints are visible on x-rays, and the use of basic clinical markers, but also in conjunction with the general clinical manifestations - fever, malaise, and weight lossIn the analysis of blood examined ESR, rheumatoid factor, platelet count, etc. The most advanced analysis is the titer of antibodies to cyclic citrulline-containing peptides - ACCP, anti-CCP, anti-CCP. The specificity of this indicator is 90%, while it is present in 79% of sera from patients with RA.Diagnostically important clinical features are the lack of discoloration of the skin over the inflamed joints, the development of tenosynovitis flexors or extensors of the fingers and the formation of amyotrophy, typical strains of brushes, so-called "rheumatoid wrist.The criteria for poor prognosis are:1. Early damage of large joints and the appearance of rheumatoid nodules 2. swollen lymph nodes 3. involvement of new joints in the subsequent exacerbation; 4. systemic disease; 5. persistent disease activity with no remission for over a year; 6. persistent increase in the ESR; 7. early appearance (within the first year) and high titers of rheumatoid factor 8. early (up to four months), radiographic changes in the affected joints - a rapid progression of destructive changes; 9. Detection of antinuclear antibodies and LE-cells 10. Carrier antigens HLA-DR4SymptomsRheumatoid arthritis can begin at any joint, but most often starts from small joints in the fingers, hands and wrists. Typically, joint damage is symmetric, for example if the sore joint on his right hand, then ill be the same joint on the left. The more joints afflicted the more advanced stages of disease.Other common symptoms include:Fatigue Morning stiffness. Generally, the longer the constraint, the disease activity. Weakness Flu-like symptoms, including low heat. Pain during prolonged sitting Outbreaks of disease activity are accompanied by remission. Muscle pain Loss of appetite, depression, weight loss, anemia, cold and / or sweaty palms and feet Violation of glands near the eyes and mouth, causing insufficient production of tears and saliva.TreatmentIn the presence of infection need the appropriate antibacterial therapy. In the absence of bright extra-articular manifestations (eg, high fevers, Felty's syndrome or polynervopathy) treatment of joint syndrome begin with the selection of non-steroidal anti-inflammatory drugs (NSAIDs). At the same time in the most inflamed joints injected corticosteroids.
