Rheumatoid arthritis is an inflammatory disease that affects symmetrically located joints, connective tissue, and internal organs. Deformations occurring in the joints disrupt their activity and limit their movements.

According to experts, up to 40 million people in the world suffer from rheumatoid arthritis. According to the Russian Ministry of Health, 300 thousand people are sick in Russia. According to unofficial estimates, 800,000 people are affected by the disease in the country. There are no exact statistics.

The discrepancy in statistical data is explained by the fact that it is difficult to determine the disease at the initial stage. The form of the disease is similar to the appearance of other diseases. Only 1% of patients in the country receive the necessary treatment.

The mortality rate from the disease is underestimated. Often the cause of death is declared to be heart disease, even though it was affected by rheumatoid arthritis. Inaccurate diagnosis and improper treatment result in rheumatoid arthritis leading to disability within a few years.

Causes of the disease

Scientists have not discovered the microorganisms that cause rheumatoid arthritis. Observational data suggests that some people are genetically predisposed to this disease, although the disease is not directly transmitted from parents to children. No one can say for sure how to treat rheumatoid arthritis.

In a third of patients, the disease began after an infection. The first signs appear for no reason. Doctors consider rheumatoid arthritis to be a disease that develops from several causes. Among them are the genetic factor and external influences: viruses, injuries, allergies, stress, smoking.

For reasons that are still unclear, the immune system gets confused and acts against its own body, producing antibodies that destroy joints and internal organs. The coordinated work of cells goes astray. Inflammation is caused by cytokine proteins, which form 90% of lymphocytes and 60% of macrophages, tissue cells that destroy harmful bacteria.

The immune system identifies cartilage cells as foreign and seeks to destroy them. The inflammation becomes constant.

Important! An autoimmune reaction is considered the main cause of the disease. Doctors associate the pathogenesis of rheumatoid arthritis with disruption of the normal functioning of lymphocytes.

Risk factors

The causes of the disease include:

• infectious diseases;
• age characteristics;
• hereditary predisposition;
• stressful situations;
• joint injuries;
• unhealthy external circumstances.

Doctors call the most dangerous infections sore throat, flu, measles, viral hepatitis, skin herpes, mumps, and infectious mononucleosis. 40% of cases of the disease begin during sore throat and flu, or during periods of exacerbation of chronic ailments. The first symptoms appear. Treatment of rheumatoid arthritis, after clarifying the diagnosis, is better to start immediately.

Women are more than three times more susceptible to the disease than men. The reason for this is the hormonal specificity of the female body. The signs of rheumatoid arthritis in women at the first stage of the disease are peculiar. Hormonal levels change during childbirth and menopause. The risk of developing rheumatoid arthritis in people in their thirties is lower than in the elderly and children. But juvenile rheumatoid arthritis also affects young people.

In half of the cases, the onset of the disease is provoked by severe psycho-emotional situations. Death of loved ones, job loss, divorce, strong emotions. Even one-time hypothermia of the joints and overexertion in athletes can lead to illness.

Rheumatoid arthritis in children is provoked by:

• viral diseases;
• bacterial infections;
• joint injuries;
• body hypothermia;
• prolonged exposure to the sun;
• changes in hormonal levels during puberty.

Signs and symptoms. Treatment of rheumatoid arthritis

At the initial stage, rheumatoid arthritis has no clear symptoms and is similar to colds or arthritis.

Not everyone knows the difference between arthritis and rheumatoid arthritis, which affects internal organs, and do not rush to see a doctor. The first signs of rheumatoid arthritis in the latent stage are:

• discomfort in small joints;
• color of the skin;
• temperature increase;
• morning feeling of stiffness;
• weakness, irritability;
• bad feeling.

Stages of the disease

The stages of development of the disease differ in the time of changes that occur, in the limitation of joint movements and in radiology data.

1. Duration first stage– six months. No changes are felt;
2. Second stage lasts more than a year. There are restrictions in movements;
3. On third stage joints are deformed. Self-service remains possible.
4. Fourth stage. Numerous cysts, osteoporosis, dislocations. Violation of all types of activities.

At-risk groups

The risk group includes people who often suffer from infectious diseases, patients with excessive body weight, and smokers. The risk of getting sick is higher in families where there are patients with rheumatism. The main age of onset of this rheumatoid arthritis is after forty-five years, although the disease begins at any age.

There is an increased risk of getting sick in people in professions that involve excessive stress on the joints. Women get sick three times more often than men. In them, rheumatoid arthritis is detected later. In men, the disease is more acute than in women.

Juvenile rheumatoid arthritis can begin acutely. Children are not able to tell what is happening to them. In children under 16 years of age, the disease in its first stages occurs in a non-standard manner. Parents are in no hurry to see a doctor; rheumatoid arthritis in children is progressing, although a blood test can reveal it; reactive protein in rheumatoid arthritis will indicate the culprit of the ailment.

Girls get sick twice as often as boys. Rheumatoid arthritis in children cannot be completely cured. Treatment lasts a lifetime. When there is no proper treatment, juvenile rheumatoid arthritis leads to disability.

Diagnosis of rheumatoid arthritis

Anamnesis and tests help to recognize the disease. The doctor helps:

• interviewing the patient;
• inspection;
• blood tests;
• test for anticitrullinated antibodies;
• analysis of joint fluid.

Instrumental study methods speed up diagnosis:

• arthroscopy;
• X-ray of the affected organ;
• scintigraphy;
• biopsy of synovial membranes;
• ultrasonographic studies.

Treatment of rheumatoid arthritis

Conservative method

Traditional treatment for rheumatoid arthritis includes:

• pain reduction;
• slowing down the inflammatory process;
• prevention of joint deformities;
• rehabilitation.

Important! In case of exacerbation of the disease, bed rest, joint immobilization, and painkillers are recommended. Non-steroidal anti-inflammatory drugs are used.

If they do not produce an effect, after three months basic medications are prescribed, without which treatment of rheumatoid arthritis is impossible:

• cytostatic immunosuppressants;
• aminoquinoline drugs;
• D-penicillamine;
• Methotrexate.

If basic medications are ineffective, corticosteroids are prescribed. They give a quick effect, but can lead to complications. To prevent this from happening, treatment continues under dispensary supervision. Nursing process for rheumatoid arthritis helps in successful treatment. The patient needs help.

Treatment of rheumatoid arthritis is effective when different methods are used together, including physical therapy. For rheumatoid arthritis, plasma cutter, ultraphonophoresis, thermal effects, other physiotherapeutic procedures, and massage are used. Exercise therapy for rheumatoid arthritis helps maintain the mobility of the affected joints. Full treatment of rheumatoid arthritis takes place on an inpatient basis.

Treatment of rheumatoid arthritis continues in Russian sanatoriums. Each sanatorium has its own rehabilitation programs.

In this video, Elena Malysheva will talk about the treatment of rheumatoid arthritis

Surgical treatment

During surgery, arthroscopy is more often used, when instruments are inserted through a puncture into the joint cavity, where medications are injected. To prevent the destruction of cartilage, partial or complete synovectomy is used - excision of the synovial membrane of the joint and removal of diseased tissue. Endoprosthesis replacement is effective when installing an artificial prosthesis can help.

Treatment of rheumatoid arthritis with folk remedies

The use of natural remedies eliminates relapses. For this purpose, restorative diets, compresses, and herbal tinctures are used. Self-treatment of rheumatoid arthritis at home is carried out using available means, including:

• compress of raw potatoes at night;
• weak vinegar solution to relieve acute pain;
• coniferous balm from pine twigs, rose hips, crushed cloves;
• garlic and onion peels.

Onion peel. Treatment for rheumatoid arthritis with this remedy is considered effective, and it partially affects the symptoms. Rheumatoid arthritis cannot be treated with this remedy alone. Onion peels contain a large number of biologically active microelements, including the anti-inflammatory substance quercetin.

Among other means:

1. Bay leaf decoction;
2. Fresh leaves of coltsfoot and cabbage plants;
3. Black radish juice with honey and table salt for rubbing;
4. Homemade ointment from chicken eggs.

For herbal therapy, golden mustache, radish, hawthorn, barberry, and birch are suitable.

Rheumatoid arthritis of the knee joint, which worries older people, does not disappear when using these remedies, but the pain decreases. With wax wraps, rheumatoid arthritis of the fingers also does not disappear, the pain subsides for a while. There are many tips and recipes on how to treat rheumatoid arthritis, but it is worth remembering that treatment with folk remedies will not cure rheumatoid arthritis. Scientists know how drinking soda affects rheumatoid arthritis, as well as the fact that soda does not cure the disease.

Treating rheumatoid arthritis at home alone does not cure the disease.

Treatment of rheumatoid arthritis at different stages involves the use of a set of drugs and medications with different pharmacological effects. To quickly relieve pain, non-steroidal anti-inflammatory drugs and corticosteroids are used in the form of tablets and suppositories:

• indomethacin;
• diclofenac;
• Brufen;
• prednisolone;
• indamethacin and a number of other drugs.

The use of these drugs is not a treatment; they relieve pain, but do not eliminate symptoms. Treatment for rheumatoid arthritis is still necessary. To support the affected cartilage, drugs from the group of chondroprotectors are used. Medicines containing chondrotin and glucosamine restore tissue by affecting the cause of the disease.

Therapeutic agents include drugs that affect the causes of the disease. Five groups of drugs are most commonly used:

• antimalarial drugs;
• gold salts;
• D-penicillamine;
• Immunosuppressants;
• sulfasalazine.

Unlike drugs with gold salts, sulfasalazine has fewer side effects. For rheumatoid arthritis, it is used for a long time. Scientists are looking for ways to treat. New biological drugs for the treatment of rheumatoid arthritis will appear in 2017.

There are many drugs, but they are selected individually, taking into account side effects. Thus, methotrexate for rheumatoid arthritis is prescribed to the patient only together with folic acid.

There are medications that are not prescribed during pregnancy. Rheumatoid arthritis and pregnancy are cases where the doctor will not prescribe just any medicine. Plaquenil is contraindicated in pregnant women for rheumatoid arthritis.

The physician's responsibility for the correct treatment is provided for by the international standard for the treatment of rheumatoid arthritis. It is enough for the doctor to see the tests and symptoms. Treatment of rheumatoid arthritis will begin in a timely manner.

Prevention of rheumatoid arthritis and nutrition

Academician Vadim Mazurov believes that prevention methods are standards:

• healthy lifestyle;
• playing sports;
• avoiding hypothermia;
• protection from stress;
• careful attitude towards your health.

Nutrition for rheumatoid arthritis should be complete.

Diet for rheumatoid arthritis

The diet for rheumatoid arthritis includes vegetable oils, fresh fruits and vegetables, and fatty sea fish. The diet for rheumatoid arthritis of the joints limits the consumption of pickled, salted, smoked, and spicy foods.

Important! It is important to eat greens: spinach, onions, parsley, rich in vitamin B. Folic acid plays an important role in rheumatoid arthritis. The drug methotrexate used for rheumatoid arthritis has a toxic effect on the body, which is neutralized by folic acid.

Other vitamins for rheumatoid arthritis are no less important than B vitamins. It is important to include black currants, apples, gooseberries, lemons, green tea and rose hips in your diet.

Complications

Against the background of rheumatoid arthritis, succulent blood vessels, rashes, and eye lesions develop. The cardiovascular system suffers. Patients suffering from rheumatoid arthritis suffer from infectious diseases due to weakened immunity. Therapy drugs have an immunosuppressive effect.

At the first signs of rheumatoid arthritis, you should go to the hospital. Doctors know all the symptoms, treatment of rheumatoid arthritis will begin without delay. Treatment with folk remedies alleviates pain more. Treatment of rheumatoid arthritis at home is carried out under the supervision of a doctor. Treatment of rheumatoid arthritis is a long process. Rheumatoid arthritis is treated by a rheumatologist.

Conclusion

With rheumatoid arthritis, only an accurate diagnosis and early treatment will prevent the development of the disease and maintain health. Contact medical institutions. It is important to start treating rheumatoid arthritis immediately. Only doctors know how to cure rheumatoid arthritis.

The video details the causes, symptoms and treatment of rheumatoid arthritis.

Arthritis – this is inflammation of the joint. With arthritis, pain is observed when moving or lifting heavy objects, the joint loses mobility, swells, changes shape, and the skin over the joint turns red.

Main symptoms of arthritis:

Pain and swelling in the joints.

Morning stiffness in the joints of the hands.

Weakness, fatigue.

Increased body temperature.

Losing weight.

Types of Arthritis
There are two types of arthritis:

Inflammatory arthritis.

Degenerative arthritis.

Inflammatory arthritis is associated with inflammation of the membrane lining the joint from the inside:

Infectious (purulent) arthritis

Rheumatoid arthritis

Gout

Degenerative arthritis is associated with damage to articular cartilage:

Osteoarthritis

Traumatic arthritis

Suppurative arthritis occurs when pathogens of a pyogenic infection penetrate into the joint. Purulent arthritis is primary and secondary. Primary arthritis occurs in wounds. Secondary arthritis develops when an infection from adjacent tissue or blood enters the joint. Damage and destruction of cartilage is observed. Arthritis can lead to periarticular cellulitis. In this case, severe pain, high fever, and chills are observed.

Rheumatoid arthritis- a systemic disease with joint damage such as polyarthritis.

The causes of rheumatoid arthritis have not yet been clarified. The role most often pointed to is streptococci, viruses and other microorganisms, as well as genetic factors.

Damage to one’s own immune system plays a special role in the development of rheumatoid arthritis. The presence or absence of rheumatoid factor in the blood determines two forms of rheumatoid arthritis.

The seropositive form of arthritis is more severe. The disease usually begins acutely, with morning stiffness, pain, and fever. First, one joint is often affected (monoarthritis), and after a few months other joints are involved in the process.

Rheumatoid arthritis often affects the small joints of the hand. Rheumatoid arthritis is characterized by persistent pain that increases with movement and decreases at night. Arthritis is accompanied by muscle atrophy and the formation of rheumatoid nodules in the skin.

Arthritis due to influenza
Most patients with influenza have sensations of damage to muscles and joints. During the peak of the flu, joints are less likely to be affected. However, after 10-15 days the likelihood of arthritis increases. Arthritis due to influenza is usually allergic in nature and often becomes chronic.

Lyme disease caused by spirochetes after a tick bite. Very often, at the first stage of the disease, neck stiffness appears, and after a few months the patient develops arthritis.

Infectious-allergic arthritis begins acutely, develops as a result of increased sensitivity of the body to an infectious pathogen (streptococcus, staphylococcus).

Infectious-allergic polyarthritis is more common in young women. There is a connection between the occurrence of arthritis and acute upper respiratory tract infection. 10 - 15 days after an acute infection, during the period of greatest allergization of the body, acute inflammation of the joints occurs. But if patients with acute respiratory diseases take anti-inflammatory drugs, the process in the joints is sluggish.

Polyarthritis
Non-infectious polyarthritis develops with systemic diseases - allergies, connective tissue diseases (lupus erythematosus, scleroderma), blood diseases and hemorrhagic diathesis, malignant tumors, diseases with deep metabolic disorders (uremia, gout), injuries.

Inflammation of periarticular tissues in arthritis
With periarthritis, bursitis, tendinitis and some other arthritis, the joint capsules, tendons, and ligaments become inflamed. The causes of these diseases are mechanical overload due to flat feet, professional and sports overload, spinal curvature, and injuries. Periarthritis often affects the shoulder and hip joints.

Arthritis treatment

The duration of arthritis is 1-2 months. However, in some patients it persists for a longer period.

Recurrence of arthritis is possible after repeated acute infection or hypothermia. Under the influence of anti-inflammatory therapy, the shape and size of the joints are normalized, and function is restored.

Therapy is carried out with non-hormonal anti-inflammatory drugs: brufen, flugalin, naproxen, butadione, indomethacin, voltaren.

Desensitizing therapy - suprastin, diphenhydramine. Additionally, ultraviolet irradiation, vitamins, and low-carbohydrate foods are recommended. The disappearance of arthritis must be confirmed clinically and radiologically. Typically, long-term treatment is required, followed by observation by a rheumatologist, regular laboratory (2-4 times a year) and radiological (1-2 times a year) monitoring of the activity of inflammation for many years.

Several groups of anti-inflammatory drugs have been developed and successfully used to combat arthritis. In acute cases, they can be administered by injection directly into the site of inflammation. Restoring joint mobility and muscle elasticity is achieved using special gymnastics and massage techniques. A course of treatment with chondroprotectors is carried out, stimulating the restoration of joint cartilage.

Non-pharmacological treatments for arthritis include:

Reducing the load on joints: reducing body weight; selection of orthopedic shoes with soft soles and fixed heels, use of instep supports, knee pads, and canes when walking.

Therapeutic exercises, which should be carried out in a sitting position, lying down or in water (i.e. without static loads) and should not cause increased pain in the joints. Exercises on bent knees and squats are completely excluded. Swimming lessons are recommended.

Physiotherapeutic treatment: thermal procedures, ultrasound, magnetic therapy, laser therapy, acupuncture, hydrotherapy, massage, electrical pulse stimulation of muscles. Any physiotherapeutic procedures are carried out in the absence of contraindications.

Getting rid of bad habits: quitting smoking, excessive consumption of coffee drinks.

Pharmacological treatments for arthritis:

Local therapy: use of non-steroidal anti-inflammatory creams, ointments or gels; intra-articular or periarticular administration of glucocorticosteroids.

For moderate joint pain, simple painkillers (paracetamol) are used; if their effect is insufficient, non-steroidal anti-inflammatory drugs are prescribed.

Currently, much attention in the treatment of arthritis is paid to drugs that can eliminate not only pain, but also prevent, slow down or reverse the development of pathological processes occurring in the joints during arthritis. Such drugs are called chondroprotectors, i.e. drugs that protect cartilage. They are able to stimulate the synthesis of the main substance of cartilage and at the same time inhibit the production of an enzyme that destroys cartilage. Thus, chondroprotectors enhance regenerative processes and suppress destructive processes in cartilage. When prescribed, pain is often significantly reduced, range of motion increases, and joint function is restored. Chondroprotectors are well tolerated and very rarely cause side effects.

Surgical treatment (joint replacement), which is used only for the most advanced forms of arthritis.

Treatment of rheumatoid arthritis
Rheumatoid arthritis cannot be completely cured. Modern treatment methods are aimed at reducing inflammation, improving joint function and preventing disability in patients. Early initiation of treatment improves prognosis. Optimal treatment includes not only drug therapy, but also exercise therapy, lifestyle changes and other measures. There are two types of drugs used in the treatment of rheumatoid arthritis: anti-inflammatory or fast-acting “first-line” drugs and slow-acting “second-line” drugs (also called disease-modifying or disease-modifying drugs). The first group of drugs includes aspirin and hormones (corticosteroids), which relieve inflammation and reduce pain. Basic drugs (for example, methotrexate) cause remission and prevent or slow down joint destruction, but are not anti-inflammatory drugs. Surgical treatment is used to correct severe joint deformities.

Treatment of reactive arthritis
General hygienic measures for the prevention of intestinal infections, the use of condoms to reduce the risk of infection with genitourinary chlamydia and other sexually transmitted diseases.

Treatment of infectious arthritis
Infectious arthritis usually requires several days of hospital treatment, followed by medications and physical therapy sessions over several weeks or months.

Treatment of arthrosis
Gymnastics 2-3 times a week for 15 minutes.
Periodic preventive treatment of arthrosis 1-2 times a year (chondroprotectors, physiotherapy, manual therapy, massage).
Gentle exercise regimen and balanced nutrition.

Treatment of infectious-allergic arthritis
Antimicrobial, anti-inflammatory and desensitizing drugs are used. Before prescribing antibiotics to a patient with arthritis, their tolerance is determined. It is advisable to carry out balneological treatment (sea, hydrogen sulfide, radon baths) after treating arthritis.

Treatment of periarthritis
Treatment of periarthritis, bursitis, and tendinitis takes 1-3 months. The pain can be relieved within a week. If periarthritis is advanced (6 months or more without proper treatment), a limitation of joint mobility of 10-20% often remains. After the acute symptoms of periarthritis have been relieved, preventive courses are required 1-2 times a year (chondroprotectors, physiotherapy, massage).

Treatment of complications of arthritis
Sepsis is a common complication of arthritis. Late complications include fistulas, ankylosis, dislocations, arthrosis, and limb deformities. Treatment for complications of arthritis depends on the duration of the disease. Suppurative arthritis should be treated promptly. For purulent arthritis, the inflammatory fluid is sucked out and the joint is washed with an isotonic sodium chloride solution, and antibiotics are prescribed. The limb must be immobilized.

Alternative remedies for treating arthritis:

Place a piece of camphor the size of 1/4 of a piece of refined sugar into a 200-gram bottle. Fill 1/3 of the bottle with turpentine, 1/3 with sunflower oil, 1/3 with wine alcohol. Let it brew for 3 days. Rub dry into the area of ​​the sore joint at night and tie as a compress.

Apply celandine juice generously to the affected joints, after a few days the pain decreases. The more juice you apply to the joints, the more active the treatment.

1 tsp. pour celandine with 1 cup of boiling water, leave for 1 hour. Drink 50 g 3 times a day 15 minutes before meals for 1-2 months.

1 tbsp. l. woodlice herbs (medium chickweed) pour 1 cup of boiling water. Leave, covered, for 4 hours, strain. Take 1/4 cup 4 times a day before meals.

1 tbsp. l. fresh purslane herb pour 1 glass of cold water. Boil for 10 minutes after boiling. Leave, covered, for 2 hours, strain. Take 1-2 tbsp. l. 3-4 times a day.

Infuse 20 g of horse chestnut flowers in 0.5 liters of alcohol or vodka for 2 weeks. Use the tincture as a rub.

Take 50 g of mullein flowers (bear's ear) and leave for 2 weeks in 0.5 liters of vodka or 70% alcohol. This tincture can be used for rubbing as a pain reliever.

3 tsp. Boil the rhizomes and roots of yellow gentian for 20 minutes, add 3 glasses of water. Leave, covered, for 2 hours, strain. Take 1/2 cup 3-4 times a day before meals for arthritis of various origins.

Pour 1 glass of walnut partitions with 0.5 liters of vodka and leave for 18 days. Take 2-3 times a day for a month.

RHEUMATOID ARTHRITIS

DEFINITION

Rheumatoid arthritis (polyarthritis) is a chronic inflammatory disease of the joints of the extremities.

ETIOLOGY AND PATHOGENESIS

CLINICAL PICTURE

The disease manifests as persistent arthritis (usually polyarthritis) with early and preferential involvement of the wrist, metacarpophalangeal, proximal interphalangeal joints of the hands, and metatarsophalangeal joints. Any joints of the limbs can be affected. Characterized by a feeling of morning stiffness, pain, swelling of the joints, hyperthermia of the tissues above them (skin color does not change), symmetry of the inflammatory process. Typically there is a gradual onset of the disease with wave-like fluctuations in the severity of symptoms (sometimes even more or less long-term remissions are noted at the beginning of the disease), a slow but steady progression of arthritis, and the involvement of more and more new joints. Sometimes rheumatoid arthritis begins and for a relatively long time can manifest itself as monoarthritis of a large, often knee, joint. There is also a variant of the acute onset of the disease, in which, in addition to damage to the joints, high fever and extra-articular manifestations (serositis, carditis, hepatolienal syndrome, lymphadenopathy, etc.) are noted.
The advanced stage of the disease is characterized by deforming, destructive (radiological) arthritis. Typical deformations of the metacarpal phalanx (flexion contractures, subluxation), proximal interphalang (flexion contractures) and wrist joints - deviation of the brush in the outside (the so -called rheumatoid brush) and the plusnephalangic joints (the hammer -shaped shape of the fingers, their sizes, flat feet, the Halls of the Valgus, constituting the concepts of concepts. rheumatoid feet. Inflammatory or fibroproliferative changes may predominate in individual joints. More often, changes in the joints are of a mixed nature.
Extra-articular (systemic) manifestations of rheumatoid arthritis are observed relatively infrequently, mainly in the seropositive (for rheumatoid factor) form of the disease, severe and generalized articular syndrome; their frequency increases as the disease progresses. These include subcutaneous (rheumatoid) nodules, which are often located in the area of ​​the elbow joint, serositis - usually moderately severe adhesive (adhesive) pleurisy and pericarditis; lymphadenopathy, peripheral neuropathy - asymmetric damage to the distal nerve trunks with sensitivity disorders, rarely motor disorders; cutaneous vasculitis, most often manifested by point necrosis of the skin in the area of ​​the nail bed, etc.
Clinical signs of damage to internal organs (carditis pneumonitis, etc.) are rarely noted. In 10-15% of patients, amyloidosis develops with predominant kidney damage, which is characterized by gradually increasing proteinuria, nephrotic syndrome, and later renal failure. Rheumatoid arthritis, which, in addition to typical joint damage, is characterized by splenomegaly and leukopenia, is called Felty's syndrome.

DIAGNOSTICS

Laboratory test results are not specific. In 70-80% of patients, rheumatoid factor is detected in the blood serum; this form of the disease is called seropositive. From the very beginning of the disease, as a rule, there is an increase in ESR, levels of fibrinogen, gamma globulins, C-reactive protein in the blood, as well as a decrease in hemoglobin.
Radiologically, there are 4 stages of rheumatoid arthritis:
. Stage I (initial) - only periarticular osteoporosis;
. Stage II - osteoporosis + narrowing of the joint space;
. Stage III - osteoporosis + narrowing of the joint space + bone erosion;
. Stage IV - a combination of stage III signs and joint ankylosis.
The earliest radiographic changes in rheumatoid arthritis appear in the joints of the hands and metatarsophalangeal joints.

TREATMENT

If an infection is present or suspected (tuberculosis, yersiniosis, etc.), therapy with an appropriate antibacterial drug is necessary. In the absence of significant extra-articular manifestations (for example, high fever, Felty's syndrome or polyneuropathy), treatment of articular syndrome begins with the selection of non-steroidal anti-inflammatory drugs: indomethacin (75-150 mg/day), ortofen (75-150 mg/day), naproxen (500-150 mg/day), 750 mg/day), less often ibuprofen (1-2 g/day); They are used for a long time (not in courses), for years. At the same time, corticosteroid drugs (hydrocortisone, metipred, kenalog) are injected into the most inflamed joints. The immunocomplex nature of the disease makes it recommended to carry out courses of psazmopheresis, which in most cases gives a pronounced effect. The instability of the results of this therapy is an indication for the addition of the so-called basic drugs: crizanol (34 mg of gold, contained in 2 ml of a 5% or 1 ml of a 10% solution of the drug once a week intramuscularly), 0-penicillamine (cuprenil, metalcaptase, 300-750 mg/day), delagil (0.25 g/day) or sulfasalazine (2 g/day). These drugs act slowly, so they must be used for at least 6 months, and if there is a clear positive effect, treatment with them must continue further (for years).
Oral corticosteroids in the absence of significant extra-articular manifestations are prescribed as rarely as possible, usually only for severe joint pain that is not relieved by non-steroidal anti-inflammatory drugs and intra-articular administration of corticosteroids in small doses (no more than 10 mg/day of prednisolone), for a short period of time and in combination with basic drugs , allowing you to subsequently reduce the dose of hormones and completely cancel them. Carticosteroids (prednisolone orally 20-30 mg/day, sometimes up to 60 mg/day or in the form of pulse therapy: metipred intravenously 1 g for 3 days) are absolutely indicated in the presence of high fever, generalized rheumatoid vasculitis. Immunosuppressants (chlorbutine - 6-8 mg/day, azathioprine - 100-150 mg/day, cyclophosphamide - 100-150 mg/day, methotrexate -2.5-7.5 mg/day for one day every week) are drugs choice in the presence of pronounced extra-articular manifestations (polyneuropathy, generalized vasculitis, etc.), and in other cases they are used only if all previous therapy is ineffective. The use of basic drugs for the treatment of rheumatoid arthritis should be carried out under the constant supervision of a physician who knows all aspects of the action of these drugs. Physical therapy aimed at maintaining maximum joint mobility and preserving muscle mass is important in treatment. Physiotherapeutic procedures (electrophoresis of non-steroidal anti-inflammatory drugs, phonophoresis of hydrocortisone, dimexide applications) and spa treatment are of auxiliary importance and are used only for mild arthritis.
For persistent mono- and oligoarthritis, synovectomy is performed either by introducing gold isotopes, etc., into the joint, or by surgery. For persistent joint deformities, reconstructive surgery is performed.

Rheumatoid arthritis- This is one of the most severe joint diseases, occurring with many complications. Rheumatoid arthritis affects people of all ages, but most often those over 30. Among women, about 5 times more suffer from rheumatoid arthritis than among men. In general, according to various scientists, this disease affects 1-2% of the population.

Not fully studied. It is believed that there is a certain hereditary predisposition to this disease. That is, it is assumed that family members of a patient with rheumatoid arthritis have a slightly greater chance of developing it than everyone else. Although it is obvious that such a statement should not sound like a verdict. This probability is not much higher than in a healthy family. A person develops arthritis only under the confluence of several unfavorable circumstances, which we will now talk about.

As you know, most types of arthritis, and, in particular, rheumatoid arthritis, are autoimmune diseases. That is, with arthritis, those immune cells-lymphocytes, which should recognize and destroy strangers invading the body (bacteria, viruses, etc.), for some reason “go off course” and perceive the cells of their own body as enemies, in first of all - joint cells. And they actively attack them, as if trying to destroy them.

The reasons why protective cells suddenly begin to regard the cells of their native organism as strangers may be different. Sometimes autoimmune aggression can be triggered by some infection or latent, indolent infection. Let's say that in approximately 40% of cases this disease is preceded by acute respiratory disease(ORZ), flu. sore throat or exacerbation of chronic infectious diseases. As recent studies have shown, after infections, individual microbes or viruses, or more often their particles, may remain inside diseased joints, to which immune cell receptors react.

Rheumatoid arthritis: symptoms and treatment

Rheumatoid arthritis is an autoimmune disease that leads to chronic inflammation of the joints. With this disease, damage occurs to the periarticular and other tissues, systems and organs of the body. For this reason, it is called a systemic disease.

Rheumatoid arthritis: symptoms and causes

The symptoms of rheumatoid arthritis are quite expressive, they are difficult to confuse with the symptoms of other diseases, even with another type of arthritis.

• swelling and inflammation of the metacarpophalangeal joints of the middle and index fingers;
• swelling and inflammation of the wrist joints;
• symmetry of inflammation of the joints, that is, when the joints on the left hand are affected, the same joints on the right hand are almost always affected;
• increased pain in the joints in the second half of the night; the pain continues until about noon, then subsides and in the evening may be practically not felt;
• at the beginning of the disease, joint pain often decreases after warming up or active movements;
• morning stiffness of joints;
• formation of rheumatoid nodules under the skin;
• increase in general body temperature;
• sometimes there is an increase in lymph nodes;
• feeling of weakness, deterioration of sleep, appetite, chills;
• reduction, sometimes significant, of body weight.

Often the initial symptoms are poor sleep, fatigue, and weakness. A person takes these symptoms for a normal ailment and does not rush to see a doctor, and as a result, this leads to further inflammation of the joints.

The causes of rheumatoid arthritis have not yet been fully studied, but scientists have identified some patterns in the occurrence of this disease, from which we can name the most likely causes of the appearance of rheumatoid arthritis, we will note the main ones below.

Rheumatoid arthritis: symptoms, treatment

Image from lori.ru

Rheumatoid arthritis– one of the most common severe autoimmune diseases in humans. It affects both men and women, but in a ratio of 1:5, that is, women get sick much more often. Collectively, this disease affects one percent of the population over 30 years of age, and there is no way to completely cure it.

A long, ongoing inflammatory process leads to the slow destruction of joint structures and damage to nearby bones and cartilage. Typically, the disease affects the ankles, ankles, knees and hands.

The impetus for the development of the disease can be an acute respiratory infection. hypothermia, stress, infection, joint injury. Sometimes rheumatoid arthritis is a complication of a number of diseases, for example, it develops after the flu or sore throat. In 80% of patients during the course of the disease, antibodies to the Epstein-Barr virus are detected.

A disorder of the immune system leads to the production of antibodies, which gradually accumulate in the body and gradually destroy one or another joint. Deformation and destruction of joints are accompanied by severe pain, high fever, stiffness of movement, insomnia, and loss of appetite.

In the absence of treatment, complete destruction of the joints can occur, that is, the person is almost completely immobilized, and in the final stages of the disease, in some variants of the clinical course of the disease, damage to blood vessels, peripheral nerves and internal organs may be observed: heart, liver, lungs, and so on.

Some very alarming symptoms of rheumatoid arthritis that are dangerous to neglect include the following:

Rheumatoid arthritis- This is one of the most severe joint diseases, occurring with many complications.

Rheumatoid arthritis affects people of all ages, but most often those over 30. Among women, about 5 times more suffer from rheumatoid arthritis than among men. In general, according to various scientists, this disease affects 1-2% of the population.

Causes of rheumatoid arthritis

Causes of rheumatoid arthritis have not been fully studied. It is believed that there is a certain hereditary predisposition to this disease, that is, it is assumed that family members of a patient with rheumatoid arthritis have a slightly higher chance of getting it than everyone else. Although it is obvious that such a statement should not sound like a verdict. This probability is not much higher than in a healthy family.

Rather, a person becomes ill with rheumatoid arthritis only under the confluence of several unfavorable circumstances, which we will now talk about.

As is known, most types of arthritis and, in particular, rheumatoid arthritis are autoimmune diseases, i.e., regardless of the “starting circumstances” that provoked the onset of the disease, with rheumatoid arthritis there is always a failure of the immune system.

As a result of this failure, immune cells-lymphocytes, which should recognize and destroy strangers invading the body (bacteria, viruses, etc.), for some reason “go off course” and react aggressively to the cells of their own body. They attack their own joints as if they recognized foreign agents in the joint cells. In particular, lymphocytes secrete special substances - inflammatory mediators, which penetrate into the attacked joint and cause the death of many of its cells, and also provoke damage to the synovial membrane of the joint.

As a result, the synovial membrane swells and hypertrophies over time, that is, it grows. Later, the overgrown synovium can grow into the cartilage and other tissues of the joint, and sometimes even into the bone, weakening the structure of the entire joint. The joint swells, becomes deformed and, without proper treatment, gradually collapses.

There are two main types of arthritis: inflammatory arthritis and degenerative arthritis.

Inflammatory arthritis is associated with inflammation of the membrane lining the joint from the inside:

• infectious (purulent) arthritis
• rheumatoid arthritis
• gout

Degenerative arthritis is associated with damage to articular cartilage:

• osteoarthritis
• traumatic arthritis

Arthritis that accompanies various diseases (flu, Lyme disease, etc.) is considered separately.

Suppurative arthritis

Purulent arthritis occurs when pathogens of a pyogenic infection penetrate the joint. Purulent arthritis is primary and secondary. observed in wounds. Secondary arthritis develops when an infection from adjacent tissue or blood enters the joint. Damage and destruction of cartilage is observed. Arthritis can lead to periarticular cellulitis. In this case, severe pain, high fever, and chills are observed.

Rheumatoid arthritis

Rheumatoid arthritis is a systemic disease affecting the joints like polyarthritis. The causes of rheumatoid arthritis have not yet been clarified. The role most often pointed to is streptococci, viruses and other microorganisms, as well as genetic factors. Damage to one’s own immune system plays a special role in the development of rheumatoid arthritis. The presence or absence of rheumatoid factor in the blood determines two forms of rheumatoid arthritis. The seropositive form of arthritis is more severe. The disease usually begins acutely, with morning stiffness, pain, and fever. First, one joint is often affected (monoarthritis), and after a few months other joints are involved in the process. Rheumatoid arthritis often affects the small joints of the hand and, less commonly, the spine. Rheumatoid arthritis is characterized by persistent pain that increases with movement and decreases at night. Arthritis is accompanied by muscle atrophy and the formation of rheumatoid nodules in the skin.

Arthritis due to influenza

Most patients with influenza have sensations of damage to muscles and joints. During the peak of the flu, joints are less likely to be affected. However, after 10-15 days the likelihood of arthritis increases. Arthritis due to influenza is usually allergic in nature and often becomes chronic.

Arthritis due to Lyme disease

Lyme disease is caused by spirochetes after a tick bite. Very often, at the first stage of the disease, neck stiffness appears, and after a few months the patient develops arthritis.

Infectious-allergic arthritis

Infectious-allergic arthritis begins acutely and develops as a result of increased sensitivity of the body to an infectious pathogen (streptococcus, staphylococcus). Infectious-allergic polyarthritis is more common in young women. There is a connection between the occurrence of arthritis and acute upper respiratory tract infection. 10 - 15 days after an acute infection, during the period of greatest allergization of the body, acute inflammation of the joints occurs. But if patients with acute respiratory diseases take anti-inflammatory drugs, the process in the joints is sluggish.

Polyarthritis

Non-infectious polyarthritis develops with systemic diseases - allergies, connective tissue diseases (lupus erythematosus, scleroderma), blood diseases and hemorrhagic diathesis, malignant tumors, diseases with deep metabolic disorders (uremia, gout), injuries.