Rheumatoid arthritis: pathogenesis, etiology

Rheumatoid arthritis: pathogenesis and etiology

Rheumatoid arthritis refers to autoimmune diseases, in which the inflammatory process occurs in the connective cartilaginous tissue, and the joints are affected.

The statistics show that 1% of the total population suffers from the disease on the globe, and this is neither more nor less than 58 million people.

The pathogenesis of the disease of rheumatoid arthritis should be considered in more detail.

Etiology of the disease

Today the etiology of remwatoid arthritis has not yet been fully clarified. However, there are two options for the onset of the disease:

1. Hereditary factor.
2. Infectious pathology.

Hereditary reasons are caused by genetic predisposition of the patient to defeat the immune system of the body. A direct relationship between the appearance of the disease and the presence of specific HLA antigens is proved in the patient.

In addition to destroying immunity, these antigens alter the normal response of the body to infectious agents. HLA block the body's defense system, its immune capacity to resist and allow the disease to "settle" in the body.

Infectious etiology. Modern medicine has data on several infectious agents that can provoke the appearance of rheumatoid arthritis.

They are viruses:

• hepatitis B;
• Epstein-Barra;
• measles;
• rubella;
• mumps;
• herpes;
• retroviruses.

And this list is not complete. Today, physicians actively discuss the role of microbacteria in the development of pathology. Microbacteria are able to express stress proteins, which are the causative agents of rheumatoid arthritis.

The arthritis risk group includes the following categories of people:

1. patients after the age of 45;
2. women;
3. people who suffer from arthritis from close relatives;
4. carriers of antigens;
5. those patients who have colds of the nasopharynx and bone defects.

Pathogenesis - autoimmune processes

At the heart of the pathogenesis of rheumatoid arthritis are autoimmune processes, disturbed at the genetic level. First, the articular membrane is damaged, then the disease acquires a polyfertative character. Next, damage and deformation of the cartilage and bone tissue begin.

In synovial fluid, the concentration of collagen degradation products increases. The influence of these factors leads to the formation of immune complexes. After that, the mechanism of phagocytosis of immune complexes is triggered, which provokes the development of rheumatoid arthritis.

The appearance of immune complexes generates platelet aggregation, promotes the formation of microthrombi, causes pathological changes in the blood microcirculation system.

Clinic of the disease

The main clinical manifestation of the disease is articular syndrome. Usually, with rheumatoid arthritis, joint damage occurs symmetrically from both sides.

The onset of the disease most often coincides with cold weather conditions and those periods when physiological restructuring takes place in the patient's body. In addition, arthritis can begin after an injury, a transferred infection, stress or hypothermia.

Before the first messengers of the disease appear, it is in the prodromal period, which can last several weeks or even months.

The main symptoms of arthritis:

• weight loss;
• weakness;
• deterioration of appetite;
• increased sweating;
• morning stiffness;

• subfebrile body temperature.

Most often, the onset of the disease is characterized as a subacute. But there is also an acute picture of the pathology: joints and muscles appear sharp pains, there is a significant morning stiffness and fever.

For the initial stage of the disease, the following symptoms are typical:

1. inflammation and puffiness of surrounding tissues;
2. prevalence of exudative processes in the joints;
3. limitation of mobility of joints;
4. painful sensations when touching the affected joints;
5. over the joints hyperemic and hot to the touch skin.

At the stage of progression of the disease, there are fibrotic changes in the joint capsule, ligaments and tendons. These degenerative processes lead to deformations, contractures and dislocations of joints.

In the joints there is a restriction of mobility. Over time, the disease can lead to a complete loss of their function. First of all, the diarthroses of the wrist are affected: wrists, phalanges and interphalanges.

1. Sore joints begin to swell.
2. Limited mobility.
3. There is pain in movement.

If the inflammatory process affected the interphalangeal joints, the fingers of the patient become spindle-shaped.

The hand of a person suffering from this type of arthrosis can not bend into a fist. The interosseous gaps fall, muscle atrophy develops.

In the end, the entire brush becomes deformed.

Then the wrist joints are affected. This is manifested by the appearance of pain in the area of ​​the wrist, edema, bone destruction, the formation of ankylosis with adjacent joints.

Deformation of the brush can lead to the fact that the fingers become shorter, one phalanx grows into the other, the joints develop a contracture.

Constant progression of the disease leads to a violation of sensitivity and the appearance of finger paresis, as a result of which they lose mobility.

• There may be pain in the forearm, which will spread to the elbow joint itself.
• The tendons of the hand and fingers are affected.
• Rheumatoid arthritis can provoke lesions of the radiolucent joint, which is manifested by intense pain when flexing the arm in the wrist, often by subluxation and ulnar involvement.
• If the elbow joint is affected, limb movement is limited, the patient feels pain, contracture develops.
• There may be an infringement of the ulnar nerve, which provokes the paresis of the corresponding zone.
• The defeat of the shoulder joint is characterized by inflammation of the clavicle and humerus, thorax and neck, muscles of the shoulder girdle.
• Changes can occur in the knee joint, ankle and foot bones.
• With prolonged and severe course of arthritis, lesions can develop in the hip joint. The inflammatory process is manifested by pain, restriction of movements, the thigh is fixed in a bent position. A severe complication of the disease may appear as ischemic necrosis of the femoral head.
• The spinal column is rarely affected. This can happen in the long course of the disease. The cervical spine suffers, the inflammation covers the atlanto-axial joint. In the neck, there are pains, and markedly limited movement.
• For the defeat of the jaw joint is typically the occurrence of pain, limiting the opening of the mouth, resulting in food intake becomes difficult.

The defeat of any joints is accompanied by their stiffness in the mornings and restriction of mobility. These factors lead to the fact that the patient becomes difficult to serve himself, he can not wash himself, comb his hair, dress, and keep a cutlery in his hand.

The defeat of other organs and systems

• Respiratory system: pleurisy.
• Cardiovascular system: vasculitis, pericarditis, atherosclerosis, heart valve lesions.
• Nervous system: neuropathy, myelitis, mononeuritis.
• Skin: hypotrophy and hypertrophy of the joints, rheumatoid nodules, vasculitis.
• Kidneys: nephritis, amyloidosis.
• Organs of vision: scleritis, conjunctivitis.
• Circulatory system: anemia, thrombocytosis.

The course of rheumatoid arthritis can occur in one of the following ways:

1. The classic option. Large and small joints are affected.
2. Oligoarthritis. Suffer large joints.
3. Arthritis with pseudo-septic syndrome. There is a fever, anemia develops, weight loss is observed.
4. Felty's syndrome. The combination of extraarticular lesions with polyarthritis.
5. The joint-visceral form.

Diagnosis and treatment

Diagnosis of rheumatoid arthritis is currently carried out on the basis of a blood test, an X-ray of the affected joints, a symptomatology characteristic of this pathology. Blood is examined for ESR, platelet count, rheumatic factor.

The most effective is the antibody titer to the citrulline-containing cyclic peptide - ACPC.

Treatment of rheumatoid arthritis completely depends on the symptoms of the disease.

• If there is an infection, the doctor prescribes antibiotic therapy.
• To treat joints in the absence of extra-articular manifestations is necessary with the help of non-steroidal anti-inflammatory drugs.
• Corticosteroids are injected directly into the joint.
• Doctors prescribe to patients the use of basic drugs and plasmapheresis courses.

Treatment of rheumatoid arthritis is a long process, which often takes years. It is very important to carry out the prevention of osteoporosis in time.

The patient should be restored balance of calcium in the body. To do this, the patient is prescribed a diet rich in this substance.

In the diet must include milk, cottage cheese, cheese, walnuts.

The patient must necessarily perform daily therapeutic gymnastics. The selection of exercises is carried out so that the joints retain muscle mass, and the joints themselves do not lose their mobility.

Strong deformity of the joints requires surgical intervention, during which the reconstruction of the articulation and restoration of its functionality is carried out.

Drug therapy is the use of the following groups of medicines:

1. basic preparations;
2. nonsteroidal anti-inflammatory;
3. immunological means;
4. glucocorticosteroids.

Treatment with basic drugs provides a slowdown in the progression of the disease and the approach of remission.

In view of the fact that pronounced deformations of the joints at the early stage of rheumatoid arthritis are absent, Basic therapy is the most effective and plays an important role in complex treatment pathology.

The most popular means of basic therapy are gold preparations, cyclosporine, methotrexate, aminoquinoline agents. If the appointments did not provide the expected effect, the doctor selects a combination of drugs that must replace the previous therapy.

Nonsteroidal anti-inflammatory ointments and remedies for rheumatoid arthritis are very effective. They provide antiviral and antibacterial action.

Glucocorticosteroids should be given in combination with delayed-release drugs. Modern methods of treatment suggest the use of monoclonal antibodies, which slow the progression of the disease.

For each patient, treatment is assigned individually. It takes into account the duration of arthritis, the degree of joint damage, the presence of concomitant diseases. The patient must strictly follow all the doctor's recommendations, only under such conditions the therapy will bring the result.

A source: http://sustav.info/bolezni/arthritis/patogenez-revmatoidnogo-artrita.html

Rheumatoid arthritis: causes, symptoms, diagnosis and treatment

Rheumatoid arthritis- a chronic autoimmune systemic inflammatory disease of connective tissue with a predominant lesion of the joints as an erosive-destructive progressive polyarthritis. The disease affects 0.5-1% of the population. Worldwide rheumatoid arthritis is spent around 58 million. human.

Etiology of rheumatoid arthritis

The causes that lead to the development of rheumatoid arthritis are unknown.

The following possible etiological factors are currently being discussed:

1. Genetic factors.In patients with rheumatoid arthritis, hereditary predisposition to impairment of immunological reactivity was established. A close correlation between the development of rheumatoid arthritis and antigens of the histocompatibility system HLA DR1 DR4, DRW4, DW4, DW14 is proved.

   The presence of these antigens encoding the immune response of the organism can modify the cellular and humoral immune response to various infectious agents and promote the development of rheumatoid arthritis.

   Family-genetic predisposition to the development of rheumatoid arthritis is proved by the increased incidence of the disease among relatives of patients; especially monozygotic twins.

1. Infectious agents. Several infectious agents have been identified, claiming the role of the etiological factor of rheumatoid arthritis. These are the Epstein-Barr virus, retroviruses (including human T-lymphotropic virus type I), rubella virus, herpes, parvovirus B19, cytomegalovirus, mycoplasma, etc.

   The researchers pay the greatest attention to the Epstein-Barr virus.

There are the following evidences of the role of this virus in the development of rheumatoid arthritis:

• increased titers of antibodies to the Epstein-Barr virus are detected in 80% of patients;
• B-lymphocytes in patients with rheumatoid arthritis are more infected with the Epstein-Barr virus than B-lymphocytes of healthy people; the virus can induce the synthesis of rheumatoid factor; an antigenic similarity between the components of the virus and the beta chain of the HLA DW4, DW14, DR.

In recent years, the role of mycobacteria in the development of rheumatoid arthritis has been discussed. Mycobacteria express stress proteins that are capable of causing arthritis in experimental animals.

In patients with rheumatoid arthritis, titers of antibodies to stressor proteins of mycobacteria are increased.

It is more likely that the expression of stress proteins is a nonspecific reaction ("acute phase response") to various infectious agents that reflect the inflammatory process.

Risk factors for rheumatoid arthritis are:

1. female;
2. age 45 years and older;
3. hereditary predisposition;
4. presence of the aforementioned HLA antigens;
5. concomitant diseases (nasopharyngeal infection, congenital defects of the osteoarticular system).

Pathogenesis of rheumatoid arthritis

At the heart of the pathogenesis of rheumatoid arthritis are genetically determined autoimmune processes, which are promoted by deficiency of T-suppressor function of lymphocytes.

An unknown etiologic factor causes the development of an immune response. Damage to the joint begins with inflammation of the synovium (synovitis), which then acquires a proliferative character (pannus) with damage to the cartilage and bones.

The intensity and clinical type of the inflammatory process is determined by the genes of the immune response. The synovium is infiltrated by CD4 + T-lymphocytes (helper cells), plasma cells, macrophages.

Activated T-lymphocytes-helpers stimulate the proliferation of B-lymphocytes, their differentiation into plasma cells. Plasmatic synovia cells produce altered aggregated IgG.

In turn, it is recognized by the immune system as a foreign antigen, and plasma cells of synovia, lymph nodes, spleen begin to produce antibodies to it - rheumatoid factors (RF).

The most important is the RF class IgM, which is found in 70-80% of patients with rheumatoid arthritis. The existence of other types of RF, IgG and IgA, is also proved. When determining in the blood of patients with rheumatoid arthritis of the classical RF, IgM is said to be a seropositive variant of rheumatoid arthritis.

Rheumatoid factor can be detected in healthy individuals (in titres not exceeding: 4), with systemic lupus erythematosus, chronic autoimmune hepatitis, Sjogren's syndrome, hemoblastoses, tumors.

In a number of cases, other autoantibodies are also detected in patients with rheumatoid arthritis (DNA, cell nuclei, blood elements, etc.).

In patients with rheumatoid arthritis who have HLA DR4, a local synthesis of antibodies to collagen II type, while the synovial fluid significantly increased the content of degradation products collagen.

It is possible that the local synthesis of antibodies to collagen is directed against the products of cartilage degradation.

Interaction of aggregated IgG with rheumatoid factors leads to the formation of immune complexes that are phagocytosed by neutrophils and macrophages of the synovial membrane.

The process of phagocytosis is accompanied by damage to neutrophils, release of lysosomal enzymes, mediators of inflammation (histamine, serotonin, kinin, prostaglandins, leukotrienes, etc.), which causes the development of inflammatory, destructive and proliferative changes in synovia and cartilage.

Development of immune complexes also contributes to platelet aggregation, the formation of microthrombi, and disturbances in the microcirculation system. Damage by the immune complexes of the joint tissues leads to further autoantibody formation and chronic inflammation.

In the pathogenesis of rheumatoid arthritis, a huge role is played by cytokines - low molecular weight protein regulators, which are mediators of growth and differentiation of hematopoietic, lymphoid and mesenchymal cells, immune responses and inflammation. They are produced mainly by cells of the immune system, bone marrow, fibroblasts, platelets, monocytes, macrophages.

Cytokines include colony-stimulating factors, interleukins, interferons, growth factors. In synovial fluid and joint tissues with rheumatoid arthritis, there are excess cytokines interleukin-1, tumor necrosis factor (TNF-alpha), granulocyte-macrophage colony-stimulating factor, interleukin-6.

These cytokines are formed by cells lining the synovial membrane, as well as macrophages and fibroblasts located below it (Wenblatt, Gravallese, 1997), and have the ability to significantly stimulate the inflammatory process by the following mechanisms:

• increased synthesis of pro-inflammatory prostaglandins;
• expression of several classes of adhesive molecules on cells of the synovial membrane (selectins, integrins, adhesion molecules of vascular cells, molecules 1 and 2 of intercellular adhesion), which helps to attract lymphocytes, monocytes, macrophages into the synovial membrane;
• induction of enzymes involved in the destruction of cartilage and bone in rheumatoid arthritis, - metalloproteinases (collagenases, stomelysins, gelatinases);
• overexpression of class II molecules of the main histocompatibility complex on the membranes of various cells, which promotes the development of an autoimmune process;
• degranulation of neutrophils with a sharp increase in lipid peroxidation under the influence of granulocyte-macrophage colony-stimulating factor; increased migration to the joint cavity of leukocytes followed by phagocytosis of immune cells complexes;
• strengthening the neoplasm of the vessels in the synovial membrane, which facilitates the penetration of leukocytes and energy supply of inflammation.

In addition, interleukin-1-beta and tumor necrosis factor strongly induce the synthesis of interleukin-6, which, influencing hepatocytes, causes hyperproduction of acute phase proteins (C-reactive, fibrinogen, etc.), is involved in the development of periarticular osteoporosis, promotes the differentiation of B-lymphocytes into plasma cells and the synthesis of rheumatoid factor a.

A source: http://www.eurolab.ua/encyclopedia/295/1337/

All the patient needs to know about the pathogenesis and signs of rheumatoid arthritis

Rheumatoid arthritis is one of the most severe joint diseases. Very often it is accompanied by various complications. For rheumatoid arthritis there is no age, they can suffer as young, and sometimes even children, and older people.

Nevertheless, it occurs more often in people over the age of thirty. Symptoms of rheumatoid arthritis in women appear much more often. 5 women with this disease have only 1 male patient.

According to statistics, about 1-2% of the population of our planet suffers from rheumatoid arthritis.

In this article we will examine the symptoms of the disease, its etiology, causes, pathogenesis and stages of rheumatoid arthritis. Signs of rheumatoid arthritis in its most common variety is almost impossible to confuse with other joint diseases.

In the vast majority of cases, symptoms appear according to a certain pattern. The first signs are swelling and inflammation of the metacarpophalangeal joints on the middle and index fingers of the hands, those joints that, roughly speaking, fasten the fingers to the palm of your hand.

The temperature of the skin near the joints is increased. The first signs listed above are often accompanied by swelling and inflammation of the wrist joints. In some cases, inflammation and swelling of the wrist joints are first observed.

At the initial stage, X-ray studies may not help, because there is as yet no change in bone tissue.

With rheumatoid arthritis, symptoms are symmetrical almost always, it is a characteristic feature of the disease.

For example, if the signs appeared on the left hand, then almost always identical symptoms appear on the right. It is necessary to distinguish between rheumatism and rheumatoid arthritis.

In the second disease in the joints there is persistent inflammation, pain and swelling, which can persist for several months and sometimes even for years.

However, morning pains in intensity are comparable only with toothache. Another feature of rheumatoid arthritis is the alleviation of pain after physical exertion at the initial stage of the disease.

This is the main difference from arthrosis, with it the pain intensifies. However, the relief after the loads is temporary, at 3-4 o'clock in the morning the pain returns. The reasons for going to the doctor in most cases are reduced to painful pain, which prevents to live normally.

In most cases with rheumatoid arthritis the joints of the foot are inflamed almost simultaneously with the joints of the hand.

Inflammation of the foot joints located at the base of the fingers is easy to check: if you press the pads of the fingers, for example, on the floor, it will hurt. Like the joints of the hands, the joints of the foot are inflamed symmetrically on both legs.

After a while, several weeks or months, there is inflammation of the large joints: knee, elbow, ankle and shoulder.

Such a course of rheumatoid arthritis (first affected by foot and hand) is characteristic of relatively young people.

In the elderly, another form of the disease may occur, when the first joints are damaged, and the joints of the foot and hand begin to ache later. This form is commonly found in people older than 65 years.

If rheumatoid arthritis proceeds in a mild form, the stiffness passes through a couple of hours after awakening. However, with the aggressive form of rheumatoid arthritis, these unpleasant sensations can disappear only for dinner, sometimes later.

Rheumatoid nodules are another frequent companion of the disease. Usually the nodules resemble a pea-sized, they are quite dense to the touch. In most cases, they are located below the elbow fold.

However, the appearance of knots are subject to foot, hand, and other places. Usually nodules are few, one or two. However, in some cases, they appear much more. At this stage of rheumatoid arthritis, x-ray studies already show changes in tissues.

If rheumatoid arthritis is not treated, it will lead to deformation of the joints of the foot, hand, etc. and the loss of ability even to self-service, not to mention professional activities.

In many cases, with the symptoms listed above, there is an increased body temperature, from 3 to 38 degrees, and chills. In some patients, body weight decreases, at times very much.

What provokes the disease?

The etiology of this disease is still a mystery for doctors. Many researchers are thinking about the causes of rheumatoid arthritis, but for today there are only different hypotheses.

Some scientists believe that the etiology of the disease is associated with a genetic predisposition associated with a violation of immunological reactivity. Simply put, rheumatoid arthritis is inherited.

To the assumption that the disease is inherited, led to frequent cases of the disease among relatives. If you suffer from rheumatoid arthritis someone from close relatives, be on the alert so that in case of what not to miss the first symptoms and begin treatment.

Thus, some scientists associate rheumatoid arthritis with herpes, rubella, Epstein-Barr virus, parvovirus B19, mycoplasma, cytomegalovirus and others. Especially often, the causes of the disease are associated with the Epstein-Barr virus.

Some researchers include microbacteria expressing stress proteins in the causes of rheumatoid arthritis. This hypothesis is confirmed by animal experiments, when such bacteria provoked rheumatoid arthritis in experimental animals. This is confirmed by X-ray studies.

The risk factors include: belonging to the female sex, hereditary predisposition, the presence concomitant disease (sometimes inherited), various birth defects of bones and joints.

Pathogenesis

The pathogenesis of rheumatoid arthritis is associated with genetically determined autoimmune processes associated with lymphocyte function.

Pathogenesis: the immune response is provoked by an unknown etiologic factor (causes of appearance which is unknown), then the inflammation of the synovitis (shell) begins, then the cartilaginous and bone tissue.

Pathogenesis also includes various antibodies, for example, antibodies to collagen, which are not produced in a healthy person. This is a kind of autoimmune response to changes in the cartilaginous and bone tissues.

Rheumatoid arthritis is also accompanied by microthrombi and, accordingly, a violation of microcirculation, which makes the inflammatory process chronic.

Classification

Rheumatoid arthritis is assessed according to different signs, therefore the classification can be different.

For example,classification 1 "stage of rheumatoid arthritis":

• the initial stage, less than 6 months have elapsed since the onset of the disease;
• early stage: six months-a year;
• deployed: the disease lasts more than a year;
• late: more than 2 years have passed since the onset of the disease.

Sometimes, with rheumatoid arthritis, the stage is difficult to determine because of very slow or, on the contrary, very rapid development of the disease.

Classification 2 "disease activity", it is written in numbers from 0 to 3:

1. remission - 0;
2. low activity - 1;
3. mean activity - 2;
4. high activity - 3.

Classification 3 "ability to work": I - the patient without any problems is engaged in any activity, both unprofessional and professional; II - the patient is capable of self-service and unprofessional activities, professional f is violated; III - the patient is capable of self-service, but professional and unprofessional activity violated;

IV - all activities are violated. The joints (especially the brushes and feet) are deformed.

A source: http://pozvonkoff.ru/vsyo-chto-dolzhen-znat-patsient-o-patogeneze-i-priznakah-revmatoidnogo-artrita

Methods of treating rheumatoid arthritis

The worst enemy is an enemy you do not know. Throughout our life, the joints of the body are exposed to various influences - loads, unfavorable environment, hypothermia, trauma.

All this leads to the appearance of various diseases of the joints of man, one of the most dangerous of which is rheumatoid arthritis.

Despite the fact that pathogenesis, that is, the mechanism of the course of the disease, is known quite well, universal treatment of rheumatoid arthritis has not yet been developed.

The thing is that the etiology of this ailment is unclear - the scientists have not figured out for what reasons it develops.

Three riders of rheumatoid arthritis

Rheumatoid arthritis is a disease whose etiology is not clear.

The pathogenesis of the disease includes the development of inflammatory processes in the synovial membrane, the damage to the surrounding muscles of the ligaments and joints, which is accompanied by an autoimmune failure in the body - defender cells-leukocytes, instead of identifying and destroying foreign organisms, begin to process cells of the body, mainly tissues of the joint.The etiology of a malfunction of the immune system is also not clear.

Most often, the defeat begins with the hands, then the ailment switches to larger joints - elbows, ankle, knees. At the moment, the etiology distinguishes three factors that provoke the development of the disease:

1. Hereditary predisposition to autoimmune processes and the presence of a specific antigen in human DNA.
2. Postponed infectious diseases, ranging from herpes and shingles, ending with hepatitis.
3. The provoking factor is hypothermia, poisoning, intoxication and others.

But, the etiology also revealed a rather interesting fact: for women who prefer to breastfeed their children, the risk of an illness is reduced several times.

Clinical picture

The clinic describes the stages of the disease. There are only three degrees of development of the disease:

1. At the first degree of development only edema of synovial membranes is observed, as well as periarticular tissues - muscles and ligaments, which lead to the appearance of pain, swelling of the joint and local increase temperature;
2. At the second degree of development there is a rapid division of cells inside the joint bag, which causes it to become denser;
3. At the third degree, the newly formed cells begin to produce an enzyme that causes the destruction of the joint tissues, then leads to loss of mobility, increased pain, deforming processes.

The clinic also found that the course of the disease is most often symmetrical. That is, if the fingers on the right hand were hit, the fingers on the left limb will soon be involved in the process, moreover, the same ones.

The clinic of arthritis often has an increasing character - first the fingers of the hands, then the legs are involved in the process, then larger joints are affected. Much more rarely observed acute character - when the first large joints begin to ache, and then the smaller ones.

In addition to the damage to the hands, fingers and joints, extraarticular changes in the body are observed. Disturbances in work are observed in such internal organs as the heart, respiratory system, kidneys and even changes in blood composition. Identify such changes can only comprehensive diagnosis.

Diagnosis

Diagnosis of rheumatoid arthritis is reduced to determining the presence of several symptoms:

Diagnosis of the disease includes a mandatory blood test, as well as X-ray and ultrasound examination of the painful joint. In addition, the synovial fluid is also analyzed.

Diagnosis also includes the identification of signs in the general condition of the patient.

As a rule, patients experience stiffness all over the body in the mornings, which goes to dinner, growing pains closer to dawn, and almost complete absence of them by night.

Diagnosis, performed at the first signs of arthritis, helped to identify the disease in the early stages of development. Thus, the treatment of rheumatoid arthritis already became not meaningless - it significantly improved the patient's condition.

Methodology of treatment

As the pathogenesis of arthritis has clearly shown, the failure of the immune system, as well as the inflammatory reactions inside the joint, are most often responsible for the development of the disease.

Obviously, effective treatment can consist only in suppressing such manifestations.

That is why, drugs that are prescribed for rheumatoid arthritis affect two levels:

1. Reducing the active activity of stray white blood cells.
2. Slowing down or suppressing inflammatory processes.

Treatment of rheumatoid arthritis is based on the achievement of several goals - relief of pain symptoms and inhibition of the development of the disease, reduction and elimination of structural changes in tissues at different degrees of disease activity and improvement of patients' quality of life, an attempt to preserve them ability to work.

To achieve these goals, therapy medication is mainly used. On the second place there are new methods of non-medicamentous influence, and on the third place - treatment with orthopedic means, therapeutic gymnastics, stay in the sanatorium.

Use of medicines

As already clear, the pathogenesis of the disease can be influenced on two levels - suppressing the activity of the immune system or eliminating the symptoms of inflammation. In order to solve these problems, the patient can be prescribed drugs of the following groups:

1. Basic anti-inflammatory drugs. They are the basis of treatment and, in the absence of contraindications, are assigned to each patient. They base their action on suppressing the activity of the immune system.
2. Biological preparations are a product of biotechnologies and point to the causes of inflammatory processes, suppress immunity.
3. Glucocorticosteroids. Drugs that have a double effect - suppress the activity of leukocytes and relieve inflammation.
4. Nonsteroidal anti-inflammatory drugs - used to stop inflammation in tissues.

The best effect is achieved by a combination of both the drugs themselves and the methods of treatment: therapeutic gymnastics is carried out at the stage of remission of the disease, and to carry out the recovery itself is better in sanatoriums.

Basic anti-inflammatory components

Basic anti-inflammatory drugs (BPVP) are prescribed for any degree of arthritis of the hands and other joints, in the absence of contraindications. It is most effective to use them at the first degree of defeat - then it is possible to detach the appearance of other symptoms for as long as possible.

The drugs have become so widespread due to a number of positive effects, such as suppression of the activity of white blood cells and the preservation of the effect after withdrawal. Significant improvement in the condition of patients and slowing the erosion of joint tissues of the hands, fingers, and other joints.

By the degree of influence on the pathogenesis of the disease, the drugs are divided into two series. The first row combines the best efficacy and tolerability of the body, the second - the same effect, but with increased intoxication of the human body. The best effect is observed during treatment in a sanatorium.

The best treatment is achieved by methotrexate - the first-line drug, which is also called the gold standard by therapists of Russia. Drugs like leflunomide or arava, sulfasalazine may also be prescribed. Second-line drugs are given when the first group is ineffective.

Biological treatments

Such drugs are a product of bioengineering, contain antibodies and active molecules that suppress immune inflammation.

A remarkable feature of such drugs is the fact that they effectively interact with the BPA, mainly - methotrexate.

The main advantage of such drugs is a quick effect - the improvement of the condition occurs within a few days. Components effectively affect the joints of hands, feet and other joints.

The disadvantages of taking rheumatic treatment are the following: a high price for treatment, oppression immunity, as well as a high risk of developing allergies and autoimmune processes, due to the protein composition of the components.

The main tablets of this group are infliximab, adalimumab, ethanercept, rituximab, anakinrat, abatasept. The best effect is observed during treatment in a sanatorium.

Glucocorticosteroids

Therapeutic therapy with preparations of glucocorticosteroids allows to slow the pathogenesis of the formation of new inflamed cells by blockade of cytokines and prostaglandins.

Medications have a pronounced and rapid effect, but they can not replace the main treatment and are prescribed in conjunction with BPH, mainly methotrexate.

The minus of such drugs is that they cause a sequence of effects, which is proportional to the dose of the substance.

For the treatment of rheumatoid arthritis, these drugs are prescribed systemically and locally.

Effects after application come after 1-3 days and stay for several weeks. The best effect is observed during treatment in a sanatorium.

Non-steroidal anti-inflammatory drugs

Therapeutic therapy with non-steroid drugs is prescribed to eliminate symptoms of pain, reduce heat and suppress inflammatory processes.

They do not affect the pathogenesis of the disease, but only mask the symptoms. NSAIDs have a number of contraindications, both in terms of efficacy and tolerability.

New methods of treating the joints of hands, feet, knees and other joints in Russia are more likely to be anesthetizing, and can not change the course of the disease.

Often in medical procedures are carried out bicillin - a preparation of the penicillin group, which suppresses the inflammatory process at different degrees of its manifestation.

Often, the intake of NSAIDs achieves a reduction in pain symptoms, after which therapeutic gymnastics begins.

Sanatorium treatment

Treatment in a sanatorium is effectively combined with the intake of medicinal components.

The direction in the sanatorium can be given after the operation on the joints.

The direction is received by patients who are capable of independent movement and have retained their vital activity.

Treatment in a sanatorium is indicated for people who have been treated with hormonal drugs for treatment of rheumatoid arthritis.

The main impact in the sanatorium is the intake of mud baths, mineral waters, brine, and a calm and moderate rhythm of life, fresh air and a pleasant atmosphere.

Nontraditional methods of treatment

Treatment of the joints of the hands, legs and other parts of the body, some patients are starving. The effectiveness of this method is being questioned.

It is assumed that the hunger strike should contribute to the natural breakdown of the synthesis of cells that cause inflammation, but in fact, a person only gets exhausted.

Equally popular is the treatment with herbs.

Many of the medicinal components that are used in medicines for the treatment of rheumatoid arthritis really stand out with herbs.

Only the concentration of these substances in the natural state is so small that it can not provide proper treatment.

At the same time, gymnastics is widely used to treat rheumatoid arthritis. Just do not forget that physical education is only an auxiliary means of slowing the course of the disease, and in some cases even contraindicated.

Rheumatoid arthritis is a chronic disease that mainly affects the joints of the limbs - arms and legs.

Cure it is impossible, but you can achieve improvement and even a reduction in pain symptoms and increased motor activity.

The main thing is to start treatment on time and not to start it at the stage of remission.

A source: http://drpozvonkov.ru/pozvonochnik/bolezni/arthritis/sposobyi-lechenie-artrita.html