Rheumatoid arthritis: diagnosis, symptoms, treatment
Joints become inflamed due to the depletion of the cartilage connective tissue and bone friction
Rheumatoid arthritis is a serious chronic disease that is characterized by progressive erosive and destructive lesions and inflammation of several joints in the human body. Today, this disease is incurable: modern medicine can only reduce its symptoms and slow down further development. For this reason, a huge role in the treatment of rheumatoid arthritis plays its early diagnosis. It allows you to fight the disease in its early stages, when the joints are not too badly affected. In order not to miss the beginning of the development of the disease and the time to begin treatment, you must know the main symptoms of rheumatoid arthritis.
The signs and danger of the disease
Diagnosis significantly hampered by the fact that in most patients the disease develops gradually, the symptoms are minor. At first, the most important phase of rheumatoid arthritis, the patient may only feel a strong weakness, fatigue, lack of appetite, weight loss is. On average, from onset of illness to the patient the diagnosis «rheumatoid arthritis» it takes about 9 months. The main reason for the significant delay which is non-specificity of early symptoms of the disease.
Due to diseases of the joints of the fingers are deformed
As practice shows clear signs of rheumatoid arthritis often occur only after 1.5-2 years after onset of illness. To identify the disease at an early stage can be common symptoms that indicate the presence of inflammation, as well as the unpleasant stiffness in the joints in the morning. Other important features of rheumatoid arthritis are:
- rheumatoid nodules;
- antibodies to cyclic citrullinaemia peptide (abbreviated, ACCP) in the body of the patient ;
- the presence of rheumatoid factor in serum;
- the high content of neutrophils and some other changes in the synovial fluid caused by inflammation of the joints;
- bone erosions and periarticular osteoporosis, diagnosed by x-rays.
How to diagnose arthritis
The blood of the patient. If you suspect rheumatoid arthritis undergo special laboratory tests to determine a set of indicators. These include erythrocyte sedimentation rate, antinuclear antibodies, rheumatoid factor, C reactive protein level and more. The most accurate and modern method of detecting rheumatoid arthritis is the detection in the patient’s blood of antibodies to cyclic citrulline, which contains the peptide. In the decoding results of the study, this indicator can be referred to as anti-CCP, anti-CCP and ACCP. This method of diagnosis of rheumatoid arthritis has a very high specificity (99%) and high sensitivity (76%).
X-rays of the patient’s joint. In the later stages of rheumatoid arthritis has a very distinctive, inherent characteristics that are clearly visible on x-ray. However, in the early stages of the disease x-rays are able to detect only a small swelling of the soft tissues around the joint and incipient erosion of the bones. In addition, diagnosis of rheumatoid arthritis involves performing ultrasound and MRI.
There are specific criteria that help doctors and patients diagnose rheumatoid arthritis at a very early stage. The latest version of the list of such features was published in 2010 by experts from the American Association of rheumatology. These criteria allow us to accurately assess the degree of damage the joints of patients, disease duration and the required level of blood.
The diagnostic criteria of the American Association of rheumatology
The diagnosis of «rheumatoid arthritis» can be supplied to the patient only if its performance will match at least four of the seven criteria listed below. It is important to remember that the presence of any other diseases affecting the joints, does not preclude the diagnosis of his rheumatoid arthritis.
The appearance of nodules is a characteristic sign of the disease
Strong morning stiffness in the joints and muscles. It’s hard to move the affected joint. These sensations continue for at least 1 hour after waking up.
Arthritis with the defeat of three of more groups of joints, which is manifested by edema of the periarticular soft tissues and effusion into the cavity. Rheumatoid arthritis can capture the knee, elbow, ankle, metatarsophalangeal, metacarpophalangeal, proximal interphalangeal and wrist joints.
Arthritis, causing inflammation of the proximal interphalangeal, metacarpophalangeal or wrist joints.
Symmetrical polyarthritis, bilateral involvement of paired articulations (both knee, elbow or wrist).
The presence of rheumatoid nodules — small subcutaneous tissue near the joints, on bony projections or on the extensor surfaces of the arms and legs.
The patient has rheumatoid factor in serum. To identify this factor apply methods that give results in more than 95% of cases.
The corresponding x-ray: osteopenia and pronounced bone erosions detected by x-rays of the wrist and joints of the hands in a straight projection.
Treatment of the disease
Treatment of rheumatoid arthritis is hormonal therapy and systemic non-steroidal anti-inflammatory drugs. Today, these drugs can significantly slow down further progression of the disease, to prevent the defeat of vital internal organs. If you start treatment on time, the person will not become invalid.
Even with a severe form of rheumatoid arthritis treatment is possible, however, to completely get rid of the disease will fail. Use the most modern methods of therapy. Today, the treatment of this disease includes a range of activities.
A patient with rheumatoid arthritis need only lead a healthy lifestyle and diet. In addition, it is useful to perform daily simple exercises specially designed therapeutic exercises. Such activities significantly improve the prognosis of doctors.
Requires the use of systemic nonsteroidal anti-inflammatory drugs that help reduce swelling and relieve pain. Today these funds are used in the treatment of rheumatoid arthritis as adjunctive therapy.
The glucocorticosteroid hormone is hydrocortisone
A very important tool in the fight against disease are the glucocorticosteroid hormones, which have extremely powerful anti-inflammatory action. But it is necessary immediately to underline that long-term use of hormones can cause a number of serious consequences. Therefore, hormones should take small courses and only in the event of serious complications of arthritis. These drugs are sometimes prescribed to patients to relieve the symptoms of the disease until, until you begin to act basic drugs.
Modern medicine offers patients to use the latest drugs that modify the course of this serious disease. These drugs have the potential to significantly ease the symptoms of rheumatoid arthritis, reduce joint damage, improve functional ability and change for the better prognosis of the disease. The sooner the patient with rheumatoid arthritis start taking the drugs in this group, the faster he can cope with the illness. It is important to remember that taking these drugs should be administered only under the supervision of a doctor to avoid possible side effects.
Surgery is usually applied only in the early stages of rheumatoid arthritis. In the later stages of the disease, it loses its meaning.