Rheumatoid Arthritis
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Definition:

Rheumatoid arthritis is a chronic, potentially disabling autoimmune disease wherein the immune system attacks the joints, causing an inflammation in the joints (i.e. arthritis) as well as in other parts of the body (commonly in the lungs and the skin).


Diagnosis:

Diagnosis for rheumatoid arthritis can be determined with x-rays and blood tests. A common diagnostic step is to screen for the rheumatoid factor. An expert called a rheumatologist (specializing in disorders of joints and connective tissues) usually performs the diagnosis and manages the long-term treatment of affected patients.


Treatment:

Various treatments for rheumatoid arthritis are available. Pharmacological treatment to manage symptoms usually includes painkillers, anti-inflammatory medications, and steroids. To reverse the disease and prevent long-term damage, disease-modifying antirheumatic drugs (DMARDs) are used. In addition, non-pharmacological methods are integrated in the overall treatment, including physical therapy and occupational therapy.


Symptoms and Signs:

Rheumatoid arthritis can lead to a substantial loss of mobility due to extreme pain and joint destruction. Hallmark signs include prolonged stiffness of the joints, nodules resulting from inflamed blood vessels, fluid buildup in affected areas, and flu-like symptoms. Rheumatoid arthritis invariably presents with synovitis, a condition pertaining to an inflammation of the synovial membrane that covers the joint. As a result, the affected joints become swollen, red, tender, and warm. Synovitis also makes the joints stiff, preventing their use. Small joints are more commonly affected, including the cervical spine, hands, and feet. However, there are cases where larger joints (knees, shoulders, etc.) are also involved. As the disease progresses, the inflammation causes erosion and destruction of the surface of the joints, thus impairing movements and eventually causing deformity. Afflicted patients typically have ulnar deviation (where the fingers are deviated towards the little finger). Other symptomatic deformities include Boutonniere deformity (i.e. hyperflexion at the proximal interphalangeal joint plus hyperextension at the distal interphalangeal joint), swan neck deformity (i.e. hyperextension at the proximal interphalangeal joint and hyperflexion at the distal interphalangeal joint), Z-thumb deformity (i.e. thumb has fixed flexion and subluxation), and hyperextension of the IP joint.


Causes:

The specific cause of rheumatoid arthritis remains a mystery to this day. However, certain infections are suspected to trigger the disease.


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