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| | Title: | What is Rheumatoid Arthritis? | | Article: |
Rheumatoid arthritis is the destructive disease that
targets primarily joints. However, it also affects
many other organs and systems, including brain, heart,
kidneys, spleen, blood vessels, lungs, and muscles.
Rheumatoid arthritis affects around 1 in 100 people.
In developed countries rheumatoid arthritis is the
most common autoimmune disease. Though rheumatoid
arthritis may start at any age, it is more common
after sixty. One in twenty women over the age of 65
years suffers the disease. Economically it is very
expensive disease. Besides high direct medical cost,
there is much greater indirect medical price tag.
Rheumatoid arthritis cause many complications,
requires drastic therapies and orthopedic surgery.
Doctors estimate that rheumatoid arthritis makes a one
in-three patient permanently disabled. Half of the
patients stop work in first decade of diagnosis.
Rheumatoid arthritis is a chronic disease. It leads to
the loss of mobility due to joint destruction and
pain. The joints suffer in a polyarticular manner.
That means that many joints affected at the same time.
Usually in the beginning joint problems are
asymmetrical, later symmetrical ones. The pain
improves when you use affected joints. Also there is
the morning stiffness of all joints for an hour or
more. In osteoarthritis pain worsens in opposite way -
over the day after use.
Erosion and destruction of the joint surfaces
eventually leads to deformity. The fingers are
typically deviated towards the little finger and make
unnatural shapes: boutonniere deformity, swan neck
deformity, Z-Thumb, "squared hand”.
Besides joints problems patients suffer anemia,
gastrointestinal bleeding from drugs, splenomegaly
(big spleen) and leucopenia (Felty's syndrome), the
salivary and lacrimal (tear) glands inflammation
(Sjogren's syndrome).
Dermatological marks of rheumatoid arthritis include
subcutaneous (under skin) nodules mostly on elbows.
Lungs may get fibrosis and pulmonary effusions. Blood
vessel disorders lead to nail fold infarcts,
neuropathies and nephropathies.
Amyloidosis affects kidneys, heart and muscles. Heart
also suffers form pericarditis and valve destruction.
Dry eyes, sclera inflammation and softening may be
found. Fissure and leaking of eye humor could happen.
Neurological system is affected by neuritis and
atlanto-axial subluxation. Eventually it may lead to
compression of the spinal cord, paralysis and
quadriplegia.
To diagnose rheumatoid arthritis American College of Rheumatologists
developed the criteria.
* Morning stiffness more than an hour.
* Arthritis and soft-tissue swelling of more than 3
joints
* Arthritis of hand
* Symmetric arthritis
* Specific subcutaneous nodules
* High rheumatoid factor
* Radiological changes showing joint erosion
At least four criteria are needed to establish the
diagnosis.
Immunological and other studies help to confirm the
diagnosis: rheumatoid factor, anti-citrullinated
protein antibodies, erythrocyte sedimentation rate,
C-reactive protein, blood count, renal function tests,
liver enzymes, antinuclear antibody. HLA marker DR4 is
an important risk factor.
| | Author: | Aleksandr Kavokin, MD, PhD | | System: | Joints | | Subject: | Rheumatoid_Arthritis | | Abstract: | Rheumatoid arthritis affects around 1 in 100 people.
In developed countries rheumatoid arthritis is the
most common autoimmune disease. | | Website: | www.kavokin.com | | Time: | 16:30 | | Reference: | www.rdoctor.com | | Reference 2: | |
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©2006 Kavokin.com
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Articles by Aleksandr Kavokin, MD, PhD
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