Rheumatoid Arthritis, Symptoms, Diagnosis and Treatment

Rheumatoid arthritis - a systemic disease of connective tissue, mainly affecting small gastropathy 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. Indirect data, such as increasing the number of white blood cell count and erythrocyte sedimentation rate (ESR) indicate the infectious nature of the process. It is believed that the disease develops as a result of infection, which causes a compromised immune system in genetically susceptible individuals, with formation of so-called. immune complexes (of the antibodies, viruses, etc..), which are deposited in tissues and lead to joint damage. But the ineffectiveness of antibiotic treatment of RA is likely to indicate the incorrectness of this assumption.The disease is characterized by high disability (70%), which comes pretty early. The main causes of death from the disease are infectious complications and renal failure.Treatment focuses primarily on relieving pain, slowing disease progression and restore damaged by surgery. Early detection of disease with the help of modern tools can significantly reduce the harm that can be inflicted joints and other tissues.For the first time may occur after heavy physical exertion, emotional shock, fatigue, hormonal changes during the period, the impact of adverse factors or infection.EpidemiologyRheumatoid arthritis is distributed worldwide and it affects all ethnic groups. Prevalence of 0,5-1% (up 5% in the elderly) ratio M: F = 1:3 peak of illness onset - 30-35 yearsEtiologyAs with most autoimmune diseases, there are 3 main factors:1. Hereditary susceptibility to autoimmunity.2. Infection factor Hypothetical triggers of rheumatic diseasesParamyxovirus - viruses, mumps, measles, respiratory syncytial infectionHepatitis B virusHerpes virus - herpes simplex viruses, herpes zoster, cytomegalovirus, Epstein-Barr virus (much higher in the synovial fluid of RA patientsRetroviruses - T-lymphotropic virus3. Start-up factor (hypothermia, insolation, intoxication, mutagenic drugs, endocrinopathy, stress, etc.). For women, duration of breast-feeding reduces the risk of RA. Breastfeeding for 24 months or more reduces the risk of developing RA by half.The course of diseaseRheumatoid arthritis progresses in three stages. In the first stage, the swelling of the synovial bags causing pain, heat and swelling around the joints. The second stage is the rapid cell division that leads to compaction of the synovial membrane. In the third stage, the inflamed cells release an enzyme that attacks the bones and cartilage, which often leads to deformation of the affected joints, increasing pain and loss of motor functions.Typically, the disease progresses slowly at first, with the gradual deployment of clinical symptoms for several months or years, much less - subacute or acute. In about 2 / 3 of cases fever occurs, and the rest - a mono-or oligoarticular form, and articular syndrome often has no clinical specificity, which greatly complicates the differential diagnosis. Articular syndrome is characterized by morning stiffness for more than 30 minutes and similar expressions in the second half of the night - symptoms of "stiff gloves", "corset"; ongoing spontaneous pain in the joints, increasing during active movements. The disappearance of the stiffness depends on the activity of the process: the more activity, the greater the duration of restraint. For the joint syndrome in rheumatoid arthritis is characterized by monotony, the duration, preservation of residual effects after treatment.

There may be prodromal clinical symptoms (mild transient pain, pain relationship with meteorological conditions, autonomic dysfunction).