Rheumatoid arthritis. Diagnosis of blood, etiology, pathogenesis, causes, symptoms and treatment, clinical guidelines

Rheumatoid arthritis It is an autoimmune disease, occurring in the chronic form. The main source of disease - is the systematic inflammation of the connective tissue.

In most cases, affected joints. You must pass a comprehensive diagnosis to differentiate the disease. Treatment selects the physician rheumatologist. In the absence of timely treatment of the disease leads to serious consequences.

types of diseases

In medicine, there is a classification of rheumatoid arthritis, there are the following common types of the disease:

Title	Description
juvenile	The risk category are children and adolescents up to 16 years. At times, the disease dies down, but does not disappear completely.
Seropozitvny	Type of rheumatoid arthritis, which is readily determined by analyzes.
antibody-negative	Rheumatoid factor in the joint fluid is absent.
age-related	Type of arthritis, which is more common in women aged 35-60 years.

Establish an accurate diagnosis will help the doctor rheumatologist, a specialist will appoint tests and on the basis of the results prescribe treatment.

Stage and grade

Rheumatoid arthritis (diagnosis will determine the degree of development of pathological processes and establish an accurate diagnosis), regardless of the clinical picture progresses in a certain direction:

Title	Description
The inflammatory process in the synovium	Affected joint capsule on the inside. Synovial inflammation provokes severe pain, stiffness and swelling. Pathological condition called synovitis.
pannus formation	Against the background of inflammatory synovial tissue multiplies and divides, the shell thickens. Affected area swells and hurts. Next synovial tissue distributed by the joint space. Phenomenon in medicine is called the rheumatoid pannus.
Damage to the cartilage and joint tissue damage	As a result, the formation of new granulation tissue enzymes are released. They damage the bone cartilage. Pathological changes lead to the disintegration of the joint and increased pain, after which the deformation occurs.

There are also certain stage of the disease that a specialist determines on X-rays:

Title	Description
stage I	The initial stage of the development of rheumatoid arthritis. Pathological processes affect the joints of the fingers. The pictures are also visible densification and features of osteoporosis in the joints.
stage II	In the next stage of the inflammatory process progresses, the affected bone and appear isolated erosion.
stage III	Muscle atrophy, rheumatoid nodules are formed. The disease is characterized by the formation of multiple erosions and deformity of the joints, and subluxation.
stage IV	Joints lose their mobility, everywhere formed erosion, an increase of osteophytes and increased pain.

At each stage, there is a characteristic clinical picture. Rheumatologist is necessary to describe their condition, the doctor made a preliminary diagnosis, has appointed the most informative texts and picked up timely therapy

symptoms

Rheumatoid arthritis (diagnosis assigned patients after careful examination conducted by a physician) in the early stages of its development affects the small joints. We are talking about fingers and toes, and wrist. Symptoms develop symmetrically. Pathological changes occur slowly and may be present over a long period.

The disease is characterized by the following symptoms:

Title	clinical picture
The first signs	swelling of the bursa; pain syndrome; Local temperature increase; there is swelling in the affected area.
The main manifestations	It swells the skin around the affected joint; painful amplified; impaired motor function of joints; deformation occurs gradually; articular syndrome; general weakness, fatigue, apathy to the world.
nonspecific symptoms	increased body temperature; man disturbing chills; pain after prolonged sitting is enhanced; increased sweating; deteriorating appetite; reduced weight; pain affects the muscles; develop Felty's syndrome.

Rheumatoid arthritis occurs as the chronic disease. periods of exacerbation are replaced by remissions. The first symptom of the disease - it is morning stiffness of fingers. A person must make an effort to compress them into a fist.

Depression, anxiety, sleep problems, feelings of helplessness and low self-esteem are also satellites of rheumatoid arthritis. It is necessary to go to the hospital and get tested. Correctly selected treatment will prevent complications and adverse consequences.

Causes of

Medicine can not say why it is so often diagnosed in people with rheumatoid arthritis.

But there are certain triggers that contribute to the development of pathological processes:

• genetic predisposition;
• addictions (alcohol abuse and cigarettes);
• emotional stress, stress;
• infectious lesion;
• unfavorable ecological environment;
• violation of the hormonal balance;
• problems with intestinal microflora congenital or acquired nature.

Medical statistics show that worldwide 0.5-1.9% of the population is faced with rheumatoid arthritis. Most often it is heredity, which is less common in women. The first signs of disturbed people aged 40-60 years.

Diagnostics

Diagnosis of patients is necessary to differentiate the disease, since many diseases accompanied by similar symptoms (erythematosus, systemic sclerosis, psoriatic arthritis, polymyalgia rheumatica). Patients with rheumatoid arthritis is prescribed following diagnostic measures:

Title	Description
genetic analysis	The results show the presence of HLA-B27 gene.
General blood analysis	Research helps to assess the state of the human body. The level of leukocyte and erythrocyte sedimentation rate (ESR) increased. The results also show the development of anemia. Iron deficiency anemia provokes.
The test for rheumatoid factor	human immunoglobulins found in the blood will confirm the development of rheumatoid arthritis.
X-ray	The study reveals the damaged bone, the formation of cysts.
Ultrasonography (US)	The results will show problems with blood vessels and soft tissue.
Magnetic resonance imaging (MRI)	survey methods to help you get the maximum amount of useful information. Computer diagnostics allows you to view the affected joint layers.
Computed tomography (CT)
Puncture	For research take the synovial fluid.

A complete examination is important because on the basis of the results obtained rheumatologist doctor selects a patient an effective treatment.

When to see a doctor

Visit rheumatologist should be if there was a bilateral inflammation of the joints, they began to hurt badly. The deformation of bones, formation of subcutaneous nodules of small size as a reason to refer to a specialist.

Ambulance man required if increased body temperature, it is hard to breathe, there was a pain in the chest and heart are disrupted. With rheumatoid arthritis, you can live a full life if pathological processes are slow and calm.

The chronic form is not a sentence, especially if constantly observed at the rheumatologist and the right to be treated under its control.

prevention

There are no particular measures against the disease, but to reduce the risk of rheumatoid arthritis can be enough to remember useful recommendations specialists:

• time to treat inflammatory processes in the body, which reduces its defenses;
• excluded from the life of bad habits, especially smoking;
• defend against hypothermia;
• to treat viral diseases under the supervision of a physician;
• tempered organism by various methods and means;
• lead an active lifestyle, move more, walk, swim;
• eat right;
• observe the regime of the day;
• Avoid emotional stress;
• take vitamin complexes, especially during high-risk.

People who have a genetic predisposition, it is recommended preventive care and closely monitor their health. Not recommended as wearing tight shoes or clothing, they violate the circulation. If predominantly sedentary lifestyle, you need to stand up and do the workout.

treatments

Treatment of rheumatoid arthritis is carried out complex methods under strict medical supervision. Experts recommend to visit 1 p. in 3 months. Rheumatologists prescribe medication, given the results of medical diagnosis, the degree of development of pathological processes and the individual characteristics of the human body.

medications

Medications selects the physician rheumatologist, taking into account many factors. It is important to strictly observe and adhere to the recommendations of the destination, as there is a chance of side effects.

drug Group	Title	Description
Nonsteroidal anti-inflammatory agents	"Meloxicam", "Nimesulide"	The daily dosage of the drug is 7.5-15 mg. Tablets are taken during meal time, drinking plenty of water.
cytostatics	"Methotrexate", "sulfasalazine"	The initial dose of 2.5 mg every 12 hours. to 3 p. in a day.
glucocorticosteroid medications	"Diprospan" "piroxicam"	Adults appoint 20-40 mg 1-2 p. per day.
immunosuppressants	"Cyclophosphamide", "Azathioprine"	Given the state of the patient, the doctor prescribes for 50-2000 mg / m2 over 2-4 weeks.
chondroprotectors	"Chondroxide", "Teraflex"	The medicine is taken orally 2 tablets. 2 r. per day. The recommended course of therapy is 6 months.

Rheumatoid arthritis (diagnosis at an early stage of disease development will allow to choose the most effective treatment and prevent serious consequences) with increased activity and the absence of positive dynamics after prescription drugs are treated with plasmapheresis.

Traditional methods

Unconventional methods healers and healers in rheumatoid arthritis can reduce inflammation and pain. It is important to carry out a comprehensive treatment with medication and after consultation with a rheumatologist.

Title	Recipe	application
Broth leafs	Minced 1 tbsp leafs and fill it with hot water (2 tbsp.). Put on the fire, heat 10-15 minutes. Further infuse 10-15 hours. and strain.	Finished medicine take 3 p. per day in 1/3 Art. The course of treatment lasts 2 weeks.
potato poultice	Potatoes small wash, peel and chop on a grater. The resulting slurry was placed in a bag made of natural tissue. Then, it should be heated in a water bath or in a microwave oven.	Potatoes are applied to a patient joint, the polyethylene cover film and the bandage. Sessions should be performed every day for 10-14 days.
coniferous balsam	Mix 2 tablespoons preground hips, 1 tablespoon onion husks and 40 g of pine needles. Add to the resulting mass of garlic mashed into mush. All components mix well and pour hot water (2 L). Infuse balm recommended 25 hours.	The finished drug and filtered accept 0,5 art. 3 r. per day.

Warming and analgesic effects in rheumatoid arthritis have a vinegar application. Compress applied to the affected joint and left overnight.

Other methods

rheumatoid arthritis therapy involves the observance of dietary food:

Authorized products	prohibited products
rabbit meat, veal low fat dairy products salmon, tuna, mackerel soy products rose hips broth	Tea coffee butter fat dairy products pork, beef eggplant, potatoes, tomatoes

It is recommended to reduce the intake of carbohydrates. Extra weight increases stress on the joints, resulting in progressing the pathological processes. For the prevention of muscle atrophy should eat more food, which is composed of protein.

Physiotherapy rheumatoid arthritis act on allergic processes to improve nutrition in the affected tissues and eliminate the inflammatory process. The treatment can not be performed during the exacerbation or in the presence of high temperatures in the patient.

Title	Description
laser therapy	Is assigned to an early stage of rheumatoid arthritis. Patients are advised to visit at least 15 sessions. Laser therapy has a regenerating effect, increases local immunity.
iontophoresis	Using direct current, by which drugs are used to quickly fall directly into the area of ​​inflammation. Iontophoresis can reduce pain, swelling, improve circulation and speed up the outflow of debris.
magnetic therapy	In the treatment of rheumatoid arthritis using a pulsed magnetic field, due to which there is stimulation of blood flow, metabolism and vasodilatation. Medications, oxygen and nutrients faster fall in pathological lesions.
Cryotherapy	Cold treatment can reduce pain and inflammation, eliminate cramping periarticular tissues.
Ultra-violet rays	Radiation reduces pain and inflammation. Also contribute to the process of synthesis of vitamin D, which is required to maintain the balance of bones and joints.
Physiotherapy	Sessions are assigned to patients in order to reduce muscle spasms and rapid recovery of joint function. Massage improves blood circulation and material metabolism, prevents adhesions, ankylosis.
Massage
Mud	Warming the affected area allows you to deliver active ingredients directly into the area of ​​inflammation, which contain dirt. Procedures relieve pain, help to reduce the development of pathological changes and contribute to the restoration of joint function.

Persistent abnormalities in rheumatoid arthritis require phonophoresis and applying pulse current.

In the absence of positive dynamic after complex therapies and patient in difficult situations shown surgery:

Title	Description
Endoprosthesis	The affected joint components replace implants.
arthrodesis	During medical procedures diseased joint is removed and the bones are connected to each other. After surgery, reduced mobility, but eliminates the pain and improves stability.
synovectomy	Removed synovial inflammation around the joint of the patient.

Conducting timely operation will prevent disability rights and to restore his normal life, eliminating all symptoms of rheumatoid arthritis. Surgery is carried out under strict indications.

possible complications

Rheumatoid arthritis (diagnostic step will determine the degree of disease development) requires periodic patient visits a physician rheumatologist. Specialist monitors the health of the patient and assigns additional examination, if necessary, to promptly identify possible complications:

Title	Description
polymyalgia	Muscle affects rheumatoid inflammation.
destructive arthritis	Joints hit multiple destruction. Pathological changes affect their structure. There is pain and impaired functionality of joints.
Osteoporosis	Decreased bone density, thereby causing multiple fractures.
Heart failure	Pathological changes affect small vessels in most cases that provoke death in rheumatoid arthritis.
renal amyloidosis	A complication of the disease against which accumulates in the kidneys modified protein-lipid complex.

Rheumatoid arthritis without proper treatment provokes numerous diseases (nephritis, pleurisy, vasculitis, artherosclerosis, rheumatic fever). It is crucial to go through therapy after a full examination and constantly observed by a doctor rheumatologist.

Correctly chosen treatment of rheumatoid arthritis after medical diagnosis and compliance with all medical recommendations will prevent the rapid progression of the disease and complications. The patient can return to their usual life.

Registration of the article: Vladimir the Great

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