Rheumatoid arthritis: symptoms, treatment, diagnosis

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  • 1How to overcome rheumatoid arthritis? Symptoms, prevention and treatment
    • 1.1Kinds
    • 1.2Signs and symptoms of the disease
    • 1.3Causes and factors of development of rheumatoid arthritis
    • 1.4Clinical picture
    • 1.5Treatment
  • 2Symptomatics and therapy for rheumatoid arthritis
    • 2.1Why the disease develops
    • 2.2Forms of pathology
    • 2.3General symptoms
    • 2.4Stages of progression of the disease
    • 2.5Diagnostic measures
    • 2.6Systemic drugs
    • 2.7External therapy
    • 2.8Intra-articular puncture
  • 3Rheumatoid arthritis: symptoms, diagnosis and treatment methods
    • 3.1Causes of rheumatoid arthritis
    • 3.2Symptoms and Diagnosis of Rheumatoid Arthritis
    • 3.3Joint manifestations
    • 3.4Extra-articular manifestations
    • 3.5Flow variants and classification
    • 3.6Diagnostics
    • 3.7Seronegative rheumatoid arthritis
    • 3.8Methods of treating rheumatoid arthritis
    • 3.9Diet for rheumatoid arthritis
    • 3.10Prevention of rheumatoid arthritis
  • 4Rheumatoid arthritis - symptoms and treatment

How to overcome rheumatoid arthritis? Symptoms, prevention and treatment

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Rheumatoid arthritis- a chronic form of arthritis, in which joints are affected on both sides of the body.

In this disease, the inflammatory process affects not only the joints, but also the internal organs, thereby causing a violation of their functions.

According to ICD10 (International Classification of Diseases), the arthritis disease is assigned the ICD code M05-M14.

In rheumatoid arthritis, the joints of a person are affected on both sides of the body

In women, rheumatoid arthritis occurs 4 times more often, so the situation when a woman in old age is sick with rheumatoid arthritis is very common. At the same time, there are no age restrictions for him - a child can get sick of them. Causes, due to which the disease developed, can not be identified. A characteristic feature is the symmetrical development of inflammation - the upper or lower extremities become inflamed from both sides of the trunk. The course of the disease passes with a constant alternation of exacerbations and remission of symptoms.

Unlike rheumatoid arthritis (which is reversible), it lends itself to treatment - no significant improvement of health can be achieved only in those cases when treatment is started before the transition of the disease into a chronic stage.

Juvenile rheumatoid arthritis in children is not an exception, with incorrect treatment it leads to early disability and limited full-fledged life.

It is important to begin therapy as soon as possible and follow the appointments of a specialist, rather than using recipes from the forum of traditional medicine.


There are classifications of rheumatoid arthritis depending on the clinical and anatomical features.

The clinical classification distinguishes the following types of rheumatoid arthritis:

  • monoarthritis, oligoarthritis, polyarthritis;
  • disease with systemic manifestations: cutaneous vasculitis, digital arteritis, chronic tibial ulcers, polyserositis, rheumatoid nodules, ischemic polyneuropathy, scleritis, uveitis, dysfunction of the lungs, kidneys, heart, syndromes Felti, Stilla;
  • juvenile form;
  • Combined form of arthritis with osteoarthritis, rheumatism, multi-focal diseases of connective tissue.

The photo shows the juvenile form of rheumatoid arthritis

In accordance with the immunological characteristics of rheumatoid arthritis is divided into:

  1. seropositive (detection of rheumatoid factor);
  2. seronegative rheumatoid arthritis (examination of the rheumatoid factor in the serum of the joint fluid shows its absence).

Depending on the speed of the processes:

  • slowly progressing;
  • rapidly progressing.

By degree of development:

  1. remission;
  2. the minimum;
  3. moderate;
  4. high.

Depending on the stage of the disease:

  • okolosustavnoy osteoporosis;
  • osteoporosis in combination with narrowing of the joint gap;
  • osteoporosis in combination with multiple usuras;
  • osteoporosis combined with multiple usuras and bone ankylosis.

Rheumatoid arthritis, which develops in children under 16 years old, is called juvenile.

Pathology of development of juvenile rheumatoid arthritis in humans

Signs and symptoms of the disease

The first symptoms caused by rheumatoid arthritis of the hands develop in the metacarpophalangeal and wrist joints.

First of all, small joints of the upper and lower extremities, wrists, feet, shins, elbows suffer. Rheumatoid arthritis of the fingers is most severe.

At a neglected stage, deformation of the fingers arises - they are bent outwards. An example of such changes in rheumatoid arthritis can be seen in the photo.

Characteristic for rheumatoid arthritis is the symmetry of lesions. For example, rheumatoid arthritis of the hands affects both hands at once.

The main difference of rheumatoid arthritis is that at the initial stage of pain relief get rid of active movements, but as the disease progresses, this method does not help.

The most intense pain in rheumatoid arthritis in the morning is immediately after sleep, and towards evening they subside. However, in the advanced stage, pain does not release the patient at the end of the day.

The stage of exacerbation is accompanied by hyperemia and hyperthermia of the joint area - it becomes hot, redness is observed.

Gradually, the lesion spreads to the larger joints, including the knee and shoulder braces.

In the area of ​​affected joints, the appearance of subcutaneous nodules, which can then appear, then disappear. In size they are about 2 cm in diameter, form a circle in shape.

The nodules formed are dense in consistency and often have mobility.

There are also cases with unexpected localization - on the nape, in the forearm, on the internal organs (lungs or heart muscle can be affected).

There are atypical cases with lesion of the salivary glands, leading to an inflammatory process in them. Also, patients complain of pain in the eyes, loss of sensitivity in the extremities, discomfort in the chest, which is most clearly felt during the attempt to deep breathe.

The classic signs of the disease include asthenia, arthralgia, hyperhidrosis. In addition, a person suffering from rheumatoid arthritis, raises the meteosensitivity.

Affected by rheumatoid arthritis of hands

Symptoms of the advanced stage include the following symptoms:

  • Defeat of large muscles, femoral, gluteal, extensor forearm.
  • Changes in skin integuments are observed: they become thin, dry. Necrosis appears under the nail plate, and there is a possibility of their transition to gangrene. There is also a fragility of the nail plates - they are constantly broken, striated, practically not restored.
  • At this stage, the work of almost all internal organs and systems is broken: the gastrointestinal tract, lungs and heart, vessels, eyes.
  • On the skin, rashes, ulcers occur. There may be uterine and nasal bleeding.

Causes and factors of development of rheumatoid arthritis

Despite the fact that this disease exists for many centuries (its signs are found on the bones skeletons of ancient Indians), the reasons for the development of rheumatoid arthritis, so far and not have been identified.

To date, scientists have the following assumptions about the nature of the disease:

  1. Rheumatoid arthritis is an autoimmune disease. This point of view develops from the assumption of a violation of the body, leading to the fact that immune cells of the body instead of fighting with bacteria direct their activity to healthy tissues, cells, joints. Such a disorder can lead to various diseases, but most often it is tonsillitis, influenza, acute respiratory diseases. One of the versions is that particles of viruses accumulate in articular bags, and immune cells try to destroy them, spreading its effect on the joint itself.
  2. Rheumatoid arthritis can develop from an infectious form of the disease, as well as arthritis caused by trauma due to hypothermia.
  3. The emotional sphere is also not fully understood. There are prerequisites to believe that rheumatoid arthritis occurs against the background of emotional overstrain. A significant number of patients have similar character traits - they are impulsive and very emotional. It is with this that we can relate the cases when more often a woman is sick with rheumatoid arthritis.
  4. Another view is that arthritis can cause opportunistic pathogens in the intestine.
  5. As one of the main factors, which have to the development of the disease, is genetic. This means that a person whose relatives have been diagnosed with rheumatoid arthritis has a higher probability of developing the disease.
  6. Among the factors that can provoke rheumatoid arthritis, there is also an ecological one - bad habits, condition environment and the quality of food consumed with a certain degree of probability can affect the state of organism.

Rheumatoid arthritis affects the joints

Clinical picture

In the history of the disease with rheumatoid arthritis, several stages can be recorded, each of which has its own characteristics.

The first stage is characterized by such signs as thinning of the bone. Other signs are difficult to detect even in the picture, so early diagnosis of rheumatoid arthritis is practically excluded.

There is a consolidation of the soft tissues surrounding the joint, they thicken slightly. The development of the disease is accompanied by a narrowing of the joint gaps - which indicates the approach of the second stage.

The duration of the first stage can vary considerably.

Sometimes it can stretch for years - the first signs of rheumatoid arthritis are fixed even in childhood, and pain occurs much later when a person becomes an adult.

In the second stage, the defeat goes to the bone itself. In the upper limbs, as a rule, elbows and wrists suffer. The appearance of erosion near the cartilage leads to a restriction of mobility.

There is swelling and inflammation in the synovial bag, atrophy of the surrounding muscles is developing. Already at this stage there is pain.

An increase in the number of erosions on the bones indicates the approach of the third stage.

This stage can be traced by the results of an x-ray photograph.

This stage is characterized by a pronounced thinning of the bone, as well as extensive muscle atrophy and deformation of the joint itself.

Also in the picture is already noticeable and the deposition of salts. All these symptoms largely limit the mobility of the joint.

The fourth stage is accompanied by strong and persistent pains. Osteoporosis, erosion, cysts, stenosis of joint cracks, atrophy of the periarticular muscles - all the signs that were present earlier, are growing. The joint is deformed completely.


Treatment of rheumatoid arthritis involves an integrated approach. The treatment regimen includes:

  • basic therapeutic methods;
  • anti-inflammatory drugs;
  • physiotherapy;
  • diet.

Treatment of rheumatoid arthritis is selected after a thorough diagnosis with the study of all the symptoms.

If the doctor diagnosed rheumatoid arthritis, the treatment is based on resting the affected joints. This is an important point, since additional loads always provoke an increase in the inflammatory process.

Sometimes such a restriction in activity can manifest itself even in the appointment of bed rest with the fixation of individual joints - for this, tires are used.

Rheumatoid arthritis of the knee joint also means losing weight, so that if necessary, reduce the load.

Before treating rheumatoid arthritis with drugs, you should familiarize yourself with all side effects.

Symptoms and treatment should be determined only by a doctor, since it is important to understand how appropriate the use of a medicine.

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This is a dangerous disease and should not be run on the forum in search of the topic "cure rheumatoid arthritis quickly and independently."

Medicamental treatment may include the following groups of drugs:

  • To remove swelling and swelling, reduce pain, use non-steroidal anti-inflammatory drugs - aspirin and ibuprofen. Aspirin is used less often, since it has many side effects.
  • If the visible effect is not observed within 3 months after the onset of NSAID use, treatment Rheumatoid arthritis is supplemented with such drugs as sulfasalazine, penicillamine, plankvenil, compounds of gold. The listed drugs for rheumatoid arthritis are quite effective, but can have a serious side effect on the kidneys, liver. If side effects occur, drugs are canceled.
  • Corticosteroids can also be used to treat joint arthritis, in particular prednisolone. At the same time, he has one significant drawback - the short duration of the action.
  • Also drugs of immunodepressant class are actively used. The need for the use of azathioprine, cyclophosphamide, methotrexate in rheumatoid arthritis is increased in severe disease. But this category of drugs is not safe either - the consequences of taking them are severe damage to the liver, lungs, hematopoietic system.

Modern medicine is not limited only to drug treatment of the disease. Cure rheumatoid arthritis can be by surgery, replacing the affected joint with an artificial one.

It is extremely important for patients with rheumatoid arthritis to maintain a diet. It is necessary to reduce the consumption of salts, as well as foods rich in protein and animal fats. Sugar and alcohol are completely excluded during the period of exacerbation.

Sour-milk products, fresh vegetables, fruits and herbs, cereal dishes and seafood must be included in the menu.

Experts say that compliance with a strict diet significantly improves the condition of patients.

Treatment of rheumatoid arthritis with folk remedies is not recommended. They can be used only as an adjunctive therapy after a doctor's permission.

A source: http://Simptom-Lechenie.ru/revmatoidnyj-artrit.html

Symptomatics and therapy for rheumatoid arthritis

Rheumatoid arthritis is a systemic pathology of an infectious and inflammatory nature that affects mainly connective tissues of small joints. The course of the disease is chronic with frequent progressive relapses.

If you live with rheumatoid arthritis and do not even try to heal the pathology, the risk of possible complications from the cardiovascular, respiratory, nervous, gastrointestinal, kidney, ODA, vision, others.

Arthritis of the joints - this diagnosis, most pronounced among all other articular diseases, often leads to disability of patients (close to 70% of cases), therefore it is important to recognize the symptoms and treatment of pathology in time to begin in a timely manner.

What is it, how to cure arthritis and live after that, the treating doctor will tell - this chronic disease does not lend itself to complete cure, but it is possible to introduce it into the stage of persistent remission.

To avoid relapse, patients throughout their lives should adhere to the advice given to them by the doctor - the prevention of rheumatoid arthritis is an important stage in the treatment of the disease.

LFK, massage, rejection of bad habits and a balanced diet all this will help prolong the period of remission and improve the functionality of the joint mechanism.

Why the disease develops

Rheumatoid arthritis belongs to the group of autoimmune diseases, and since the authentic reasons provoking aggression of immunity is not revealed to this day, the true etiology of the disease is also not is defined.

It is established that such a disease as rheumatoid arthritis arises from the aggression of cells of the immune system relative to one's own organism.

Immunity ceases to recognize healthy cells, taking them for "enemy" antigens and begins their attack (in this case, under the impact are the shells).

Evidence of an autoimmune theory is the research of Dr. Evdokimenko - articular rheumatism is accompanied by the formation of rheumatoid nodes.

If you look at this node in a section (under a microscope), you can clearly see the causes of rheumatoid arthritis - nodosum education is nothing more than a congestion of cells of the immune system densely surrounding a small area already dead connective tissue.

Pathological activation of immune cells that accompanies rheumatoid arthritis, according to scientists, is provoked by the following factors:

  • the inheritance factor - the symptoms of rheumatoid arthritis can often be observed from a related line (as a rule, autoimmune diseases are transmitted genetically);
  • infectious factor - provocateurs are hepatitis (hepatitis), herpesviruses (herpes, lichen), paramyxoviruses (measles, mumps), retroviruses (often cause malignant neoplasms);
  • factor of adverse effects - here the causes of rheumatoid arthritis - is hypothermia, excessive exposure to the sun, intoxication, emotional overload;
  • internal factors - a sharp decrease and increase in the hormonal background, diseases of the endocrine glands, taking medications of mutagenic action (as a rule, these are antineoplastic drugs).

Characteristic is that the signs of rheumatoid arthritis in women (by the way, they are prone to the disease more) manifest much faster and are more pronounced than in men. However, the risk of developing pathology is reduced if a woman breastfeeds the baby for more than 2 years.

Forms of pathology

Classification of rheumatoid arthritis distinguishes many forms of this disease. The most common forms of the disease are:

  1. Juvenile, or juvenile, rheumatoid arthritis - develops in childhood or adolescence (up to 16 years). Pathology does not have a large-scale distribution (for 100 thousand not more than 15 cases). The disease progresses rapidly, it affects the internal organs.
  2. Arthritis rheumatic seropositive - the development of pathology can be rapid or subtle. This form of ailment is characterized as the most complex. In the area of ​​lesions, soreness, stiffness of movements (mainly in the morning), swelling, and hyperemia occur. Further, the symptoms of rheumatoid arthritis are aggravated - there is a destruction of the cartilaginous tissue, the joint is deformed, the amplitude of movements is significantly reduced. In addition, internal organs and human systems (kidneys, blood vessels, spleen, liver, enlarged lymph nodes) are involved in the process, larger joints, for example the knee, may suffer.
  3. Age-related rheumatoid arthritis is what older people know about this, because pathology develops due to age-related degenerative-dystrophic changes of bone-cartilaginous tissue on the background of a decrease in immune forces organism.
  4. Wandering form of pathology - a provocateur is streptococcal infection. Symptoms of rheumatoid arthritis at the initial stage are quite contradictory - a slight increase in temperature, a sore throat (all signs resemble ARVI or sore throat). In the future, the symptomatology is aggravated - a person begins to fever, symmetrically inflamed, swollen large and small joints of the hands, legs.

The answer to the question whether cure rheumatoid arthritis is unambiguous is a chronic pathology, from which it is impossible to completely get rid of.

General symptoms

By recognizing the symptoms of rheumatoid arthritis and starting treatment, you prevent many complications, keep the mobility of joints and be able to lead a habitual way of life, because the diagnosis is not yet a sentence.

Symptomatic classification of rheumatoid arthritis - identify articular and extraarticular signs of ailment.

When the joints are affected (articular symptomatology), a sharp or painful pain is noted, aggravated during movement and subsiding at rest.

Short (in the mornings), and subsequently a persistent decrease in mobility, swelling in the affected joints and their deformation.

Also often there is hyperemia, densification of the skin, the appearance of nodular neoplasms, muscle atrophy.

Most often, the brush is deformed and deformed, so-called spindle-shaped fingers (thickening of the joints), the walrus fin (fingers deformed and deflected to the side) or the swan neck (fingers in the joint area bend, and the extreme phalanx with the nail plate bends down).

In the diagnosis of rheumatoid arthritis, extraarticular symptomatology is also taken into account, the presence of which makes it possible to determine the form of pathology. As a rule, the following signs appear in the seropositive form of the disease:

  • atrophy of muscle fibers;
  • thinning and dryness of the skin, minor subcutaneous bruising (ecchymosis), necrotic tissue damage;
  • deformation and destruction of nail plates;
  • the presence of dense subcutaneous nodular neoplasms - the size is usually no more than 2 cm, there are no painful sensations on palpation.

Disturbances of digestion, myocarditis, pericarditis, pleurisy, glomerulonephritis, pathology of the central nervous system and many other complications can also be observed. Therefore, it is important to carry out timely treatment of rheumatoid arthritis.

Stages of progression of the disease

The disease progresses in three stages:

  1. There is swelling of the synovial bag of one or several joints - there is soreness in movement, swelling, mild hyperemia, morning stiffness of movements.
  2. There is a consolidation of synovia - pain is intense, constant, the stiffness of movements becomes longer (the motor function is normalized by evening).
  3. Foreign matter penetrates into the bone-cartilaginous tissue - intense soreness persists, there is complete motor dysfunction, deformation of the joints.

The disease develops gradually, the acute course of the disease at its initial stage is rarely observed.

Rheumatoid arthritis and its classification regarding the functional abilities of the patient are divided into 3 degrees:

  1. Professional work capacity is preserved - there is a slight dysfunction of the joint mechanism.
  2. Loss of ability to work of a professional nature - the dysfunction of the joint mechanism is pronounced, while the patient is capable of self-service.
  3. The total loss of legal capacity is the impossibility of self-service (disability).

To avoid disability, you need to treat the disease in time, and how to treat rheumatoid arthritis will tell the doctor after the diagnosis.

Diagnostic measures

Diagnosis of rheumatoid arthritis - an important criterion for determining the diagnosis is the presence of the following symptoms (at least 4 of them):

  • motor dysfunction in the morning;
  • the defeat of several joints (more than 3);
  • defeat of brushes;
  • symmetrical spread of pathology;
  • systemic damage to the body;
  • presence of rheumatoid nodes;
  • positive x-ray picture (defined destructive tissue change).

Studies help determine the frequency of exacerbations, severity and stage of the disease. In addition, instrumental examinations of MRI, Doppler ultrasound, arthroscopy, and x-rays are conducted.

After the diagnosis of rheumatoid arthritis is carried out, the treatment regimen and the spectrum of necessary medications are determined.

Since curing rheumatoid arthritis is completely impossible, the tactic of treatment is to eliminate symptomatic manifestations (pain reduction, puffiness, hyperemia), prevention of degenerative-dystrophic changes, prevention of deformation and loss of functionality of the joint mechanism.

How to treat rheumatoid arthritis and what to do after the onset of remission (in order to prevent relapse) the doctor will tell - to conduct self-treatment is strictly prohibited.

Systemic drugs

Treatment of rheumatoid arthritis begins with the elimination of painful symptoms, for this the patient is prescribed NSAIDs - Nimesil, Movalis, Diclofenac, others. Medicines have analgesic, anti-inflammatory effect.

At any stage of the development of the disease, the treatment of rheumatoid arthritis involves the administration of glucocorticosteroid drugs - Dexamethasone, Triamcinolone, Prednisolone, others. These drugs effectively stop all the symptoms of the pathology (inflammation, puffiness, soreness).

Without the use of basic drugs, treatment of rheumatoid arthritis is impossible - Methotrexate, Sulfasalazine, Leflunomide, others. Combining these drugs with hormone therapy, there is a marked decrease in the activity of the pathological process.

If the standard therapy is ineffective, the treatment of rheumatoid arthritis is recommended to be carried out using biological products - Humira, Simsia, Enbrel and others.

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The new generation drugs block the action of the cytokine (responsible for the development of inflammatory reactions in the body).

These drugs have proven themselves in the therapy of pathologies of an autoimmune nature.

External therapy

For external use, one-component and combined creams, ointments, gels, solutions are used. Before you treat rheumatoid arthritis, consult your doctor.

Anti-inflammatory, anesthetic ointments with NSAIDs - Indomethacin, Diclofenac, Fastum, Dolgit. Lidocaine solution - removes irritation, has analgesic effect.

Ointments used during remission to eliminate muscle tension - Mobilat, Kapsikam, Viprosal, others.

During the exacerbation, the medicinal treatment of rheumatoid arthritis is supplemented with cold compresses applied to the affected joint area 3-4 times a day for 20 minutes.

Intra-articular puncture

A manipulation is performed using a needle that is inserted into the affected joint - by removing the synovial exudate in part, excessive pressure on the joint capsule is removed. Seized fluid is sent for examination.

After this, using the same needle, an anti-inflammatory drug is injected into the joint. The procedure is quite effective, relief comes almost instantly, however, it can not be carried out more than 3 times a year.

In addition, it is recommended to undergo a course of physiotherapeutic procedures, exercise therapy, massage, carry out weight correction and in the future adhere to proper nutrition.

A source: https://sustavlechit.ru/artrit/revmatoidnyj.html

Rheumatoid arthritis: symptoms, diagnosis and treatment methods

Sometimes in public transport or in a store there are people whose hands immediately draw attention to the characteristic deformation of the hands, in which the fingers are knobby and are rejected outward. This is rheumatoid arthritis.

The disease is still a medical mystery, because the causes and mechanism of its development are unknown.

To date, it is believed that rheumatoid arthritis (RA) is a serious systemic pathology, Affects the connective tissue of the joints of our body with the development of erosive-destructive polyarthritis.

In this case, most often small joints suffer, the function of which is permanently disrupted in connection with deformation. Disease, as a rule, develops in working age from 35 to 55 years and is more often observed in women.

Causes of rheumatoid arthritis

The causes of this pathology are unknown to medicine. It is believed that the underlying disease is a pathological autoimmune process in the connective tissue of the articular membranes, but it is not clear what is the trigger factor of this reaction.

To date, there are three triggering factors for all systemic autoimmune processes in connective tissue:

  • Heredity (genetic predisposition is revealed in carriers of antigen of class MHC II HLA - DR1, DR4).
  • Infection (viruses of mumps, measles, hepatitis B, shingles, cytomegalovirus, Epstein-Barr virus, T-lymphotropic virus and others).
  • External pathogenic impact of the environment (hypothermia, prolonged exposure to the sun, medications, stress, etc.).

Symptoms and Diagnosis of Rheumatoid Arthritis

Joint manifestations

The main symptom of RA is pain in the affected joints.

Usually, the small joints of the hands, feet are first affected, then larger joints are involved in the process: wrist, elbow, knee and hip, as well as intervertebral neck joints. Rheumatoid arthritis is characterized by bilateral defeat.

The first symptom of the disease is the morning stiffness in the joints of the hands, which in mild cases last from 15 minutes to half an hour.

As the pathological process progresses, the joints increase in size due to edema, become sharply painful, movements in them are difficult, the skin over them turns red and becomes hot.

The outcome of the disease is the deformation of the joints, caused by the destruction of the cartilaginous tissue of the joint.

According to the frequency of lesions in RA, "joints of lesion" are distinguished (first and second metacarpophalangeal, proximal metatarsophalangeal, knee, wrist, elbow and ankle) and "joints of exclusion" (distal interphalangeal, first metacarpophalangeal joint brushes).

Extra-articular manifestations

In addition to articular changes, characteristic extraarticular manifestations appear in RA:

  • On the part of the cardiovascular system, it is vasculitis, atherosclerosis, pericarditis and valve apparatus damage.
  • from the respiratory system - interstitial lung diseases, pleurisy.
  • cutaneous manifestations - reticular ledo, rheumatoid nodules.
  • neurological disorders - neuropathy (compression, sensory-motor), neuritis, cervical myelitis.
  • pathology of the organs of vision - episcleritis, keratoconjunctivitis, scleritis.
  • from the kidneys - amyloidosis, NSAID-nephropathy, nephritis.
  • hematological disorders - thrombocytosis, anemia, neutropenia.

Flow variants and classification

The main variant of RA flow is classical, moreover, the disease can proceed as a mono- or oligoarthritis with lesion of large joints, with pseudo-septic syndrome, with spleen involvement and violation hematopoiesis. In childhood, juvenile rheumatoid arthritis is observed. There are also joint-visceral forms.

For the convenience of systematization of the manifestations of the RA, a special classification has been developed, according to which four stages are distinguished depending on the duration of the disease.

In addition, disease activity (DAS28), X-ray signs, immunological characteristics (seropositive and seronegative) are assessed.

Depending on the retention of the capacity for different activities, four functional classes stand out: the most severe stage of the disease is characterized by a total violation of all activities.


Diagnosis is the detailed questioning and examination of the patient, on the basis of which laboratory and instrumental methods of investigation are assigned.

From the laboratory studies, the "erythrocyte sedimentation rate" (ESR) in the general analysis is of great importance, Biochemical indices, and values ​​of acute phase parameters (rheumatoid factor and C-reactive protein).

In order to assess the degree of joint damage, X-ray examination of the affected joints is carried out in two projections.

When internal organs are damaged, special additional methods are used.

Seronegative rheumatoid arthritis

Seronegative rheumatoid arthritis is one of the variants of the course of the disease, in which the main marker of the disease, the rheumatoid factor, is absent in the blood. This type of arthritis manifests more acutely and is often accompanied by severe fever with chills and enlarged lymph nodes.

Another feature of this variant of the course of the disease is the asymmetry of the lesion of predominantly large joints, for example the knee, elbow or wrist. And only then small joints of the hands are involved in the pathological process. At the same time, morning stiffness is rarely observed, and there are no rheumatoid nodules at all.

The course of this type of RA is less severe, and the prognosis is favorable, since the erosive-destructive changes are less pronounced than in the seropositive variant.

Methods of treating rheumatoid arthritis

Modern treatment of RA is aimed at the elimination of pain syndrome, suppression of inflammation and prevention of deformity of the joints.

Persistent remission in most cases is achieved using drugs from four main groups: NSAIDs (non-steroidal anti-inflammatory drugs drugs), basic drugs (methotrexate, sulfasalazine, D-penicillamine, gold preparations and others), glucocorticosteroids and biological agents.

With a persistent pain syndrome, glucocorticosteroids are injected into the joint cavity. The autoimmune component of the inflammatory reaction is inhibited by plasmapheresis.

Basic preparations are used for years to maintain remission, three of which carefully monitor the patient's condition due to the possibility of developing side effects.

An important component of any drug complex in RA are calcium preparations used to restore calcium balance and prevent osteoporosis.

If there is a suspicion of an infection, then conduct adequate antibiotic therapy. Extra-articular manifestations are also corrected with appropriate preparations.

Great importance for improving blood circulation and restoring the functions of affected joints has the application of physiotherapy techniques, massage and regular performance of special exercises.

With severe joint deformity and inefficiency of conservative treatment, reconstructive surgeries are performed, the main purpose of which is restoration of the function of the affected joint.

Diet for rheumatoid arthritis

The purpose of the diet in RA - the normalization of metabolic processes.

This is achieved by limiting the consumption of products containing substances harmful to the disease (salt, sugar, animal fats, carbonated drinks, alcohol). Useful products are those containing a large number of group vitamins PP and calcium.

It is recommended to eat lean meats and fish, fruits, vegetables, greens, wheat bread, various cereals and soups, fermented milk products (kefir).

Prevention of rheumatoid arthritis

Basic rules that are mandatory for compliance with a person with "bad heredity

  • A healthy lifestyle (proper nutrition and gymnastics).
  • Sanitation of foci of infection.
  • Annual preventive medical examinations.

Patients in a state of RA remission should carefully follow all medical recommendations.

A source: http://osteokhondros.ru/Kogda-bolyat-sustavy/Revmatoidnyj-artrit-simptomy-dignostika-i-metody-lecheniya.html

Rheumatoid arthritis - symptoms and treatment

One percent of the people in the world probably want to know everything about rheumatoid arthritis: symptoms, diagnosis, treatment, causes, because they already suffer from this ailment.

Treatment of pathology causes considerable difficulties, because the exact cause of the development of the disease is still with absolute probability is not established.

Even for those who do not suffer from joint problems, it will be useful to know how to recognize the first signs of rheumatoid arthritis and what to do for prevention. We suggest studying rheumatoid arthritis "from" and "before".

Before you understand how to cure rheumatoid arthritis, you need to study the characteristics of the disease and understand what negative processes affect the joints.

Rheumatoid arthritis is an inflammatory disease of an allegedly infectious origin, which affects the joints of the hands and feet (often small).

The processes occurring in the body negatively affect the structure of the osteochondral tissue, and then on the muscles, tendons, respiratory organs, kidneys and the cardiovascular system.

As a result, pathological processes destroy the joints and lead to their severe deformation, loss of mobility and inability to perform the usual actions.

Scientists have not yet come to a common opinion, what triggers rheumatoid arthritis: infection, a malfunction in the work of immunity against a background of genetic predisposition, trauma. And this despite the fact that the disease is quite common and the treatment of rheumatoid arthritis under favorable forecasts can be carried out quite successfully.

Women suffer from rheumatoid arthritis more often than men, and after 55 years the risk that joints affect a chronic illness increases 3-4 times.

Despite all the "mysteriousness" of rheumatoid arthritis, he is considered to be an autoimmune pathology, which is caused by malfunctions in the work of immunity. Why? Because most often provocative factors are:

  • bad heredity - if in the family the older relatives suffered from rheumatoid arthritis, then the younger generation has a much higher chance of getting sick;
  • infections - measles, herpes, hepatitis B and other infectious diseases can weaken the immunity and destabilize its work, provoking the development of rheumatoid arthritis;
  • external and internal negative factors - regular hypothermia or joint trauma, intoxication body, including when working in harmful production can push the immunity to war against joints;
  • hormonal failures - in the first place it is a matter of changing the female body during the menopause.
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Any of these causes is capable ofdisorient the cells of the immune system that begin to attack healthy joint tissues, taking their cells for harmful and dangerous.This process is accompanied by inflammation, in which the skin over the joint heats up and turns red.

It does not allow to attribute rheumatoid arthritis to a purely infectious disease that it is not treated with antibiotics and is not transmitted through blood or mucous membranes.

It is accepted to distinguish two stages of the disease. The latent form is characterized by the absence of characteristic signs of pathology. But it has its manifestations, which help to catch the disease at the very beginning and quickly begin treatment:

  • fast fatiguability;
  • general weakness;
  • rapid weight loss;
  • temperature increase without obvious causes;
  • pain in the muscles;
  • sweating.

These symptoms of rheumatoid arthritis are pushed to the treatment, signaling that negative processes begin in the body. However, almost always the first signs of illness a person leaves without attention.

In the second stage, the disease becomes more distinct, while the clinical picture depends on many factors - the severity of the course of the disease, the localization of negative processes, the potential threat complications, etc. It is characterized by the following symptoms:

  • pain in the joints and muscles of the inflammatory nature, which has a constant or wavy character, that is, it intensifies by night;
  • there is swelling of the joints, the skin over them blushes and becomes hot to the touch;
  • increase in body temperature, which is held for a long time, with the development of inflammation feverish condition is aggravated;
  • stiffness in the affected joints in the morning - the joints not only do not obey, but any attempt to stretch them is accompanied by pain;
  • in the absence of the necessary treatment, joints are deformed - they are displaced from the central axis, they are turned out, losing the ability to perform their functions.

Rheumatoid arthritis affects joints symmetrically.Usually small joints of hands, feet, wrists, elbows, knees, less often - hip and shoulder joints, as well as the spine, are inflamed.

The number of involved in the pathological process of the joints can vary. More often - from 3 or more (polyarthritis), less often - two (oligoarthritis) or one (monoarthritis).

The most common is rheumatoid arthritis of the hands. There are several types of deformation of brushes:

  • fin of walrus - fingers begin to deviate towards the elbow;
  • the neck of the swan - the fingers are like a wave: the metacarpophalangeal joint bends, the interphalangeal joint unbends, and the distal one also bends;
  • spindle - fingers seem to twist around their axis.

With this deformation, the tendons and nerves are inevitably clamped, which causes pain, which gives to the forearm, numbness, and the sensitivity of several fingers.

A characteristic feature of rheumatoid arthritis is contracture - the fixed position of the joint (most often it is in a half-bent state).

When palpation of the affected joints:

  • increased temperature of the skin;
  • syndrome of lateral compression;
  • muscle atrophy or, conversely, muscle hypertonicity;
  • subcutaneous neoplasms (the so-called rheumatoid nodules).

Especially strongly can swell the knee joint due to the fact that its anatomical structure is favorable for the accumulation of a large amount of fluid.

The danger of rheumatoid arthritis is that it can involve in the negative process any organs that have connective tissues:

  • with lesions of the gastrointestinal tract, colitis, amyloid of the rectum and other complications are possible;
  • if the nervous system is affected, then it is possible to develop neuropathy, polyneuritis, vegetative failure;
  • with the defeat of the respiratory system - pleurisy, fibrosis, pneumonitis, bronchitis and other lung diseases;
  • when involved in the negative process of the kidneys - various types of nephritis;
  • with eye damage - conjunctivitis and other pathologies;
  • with complications of the heart and blood vessels - endocarditis and myocarditis, arteritis of the coronary vessels, granulomatous aortitis.

In addition to all the above symptoms, the raging arthritis also reacts to the skin.It becomes dry, thinner, and subcutaneous hemorrhage appears.The blood that does not come in the necessary quantities to the nail plates causes their stratification and fragility.

That is why treatment for rheumatoid arthritis should be prescribed immediately, and it is good if the patient does not ignore the initial symptoms of the disease, and seek medical help from a doctor. In this case, it will be possible to prevent deformation of the joints.

The question of how to treat rheumatoid arthritis is fully justified. How to choose the right course, if the causes of the disease are "covered in gloom" and nothing definite can be said?

Symptoms of rheumatoid arthritis joints to treatment are only partly, because to effectively combat the disease requires a thorough Diagnosis and qualification of a doctor who, according to the results of tests and tests, can assign a course that can stop rheumatoid arthritis.

Rheumatoid arthritis can be confused with rheumatism and arthrosis.

But if rheumatism "reacts" to the weather or increased physical exertion, then arthritis "nois" constantly and does not depend on climatic manifestations.

With arthrosis, during pains on the joint, pain increases, with rheumatoid arthritis, on the contrary, during active movements, they "leave".

At least four signs from the list allow you to suspect the presence of rheumatoid arthritis:

  • joint stiffness in the morning for at least 45-60 minutes;
  • change the appearance of three or more joints;
  • symmetric foci of inflammation in small joints - brushes and feet (redness, swelling);
  • presence of rheumatoid nodules;
  • change in the position of the joints, which will show X-rays;
  • the presence of a positive result on the rheumatoid factor in the general blood test.

A general blood test is an obligatory study that shows the presence of an inflammatory process and, in addition to the rheumatoid factor, helps to detect seromucoids, fibrogenes and C-reactive protein.

Only after carrying out all tests and clarifying the picture of the disease, as well as clarifying the hereditary predisposition to the disease, the doctor can prescribe the treatment.

Of course, people who have faced such a serious illness first ask: "Is it possible to cure rheumatoid arthritis?" A categorical answer "It is impossible" will be wrong, because when addressing at early stages of pathology development it will be possible to eliminate the cause (infection) and prevent deformation joints. However, it is known that restoration of the correct functioning of immunity is a complex task, therefore the prognosis of treatment is done for each patient personally.

To monitor the condition of the joints, to which rheumatoid arthritis has encroached at least once, will have throughout life.

Treatment of rheumatoid arthritis is carried out in a complex way:and with the help of medicines, and adjusting nutrition, and physiotherapy, and physiotherapy.

It is extremely important to follow the recommendations from the doctor that rheumatoid arthritis has no chance of return.

Very often patients feel that the therapeutic gymnastics are not serious, or they do not have the willpower to reconsider their diet.

The fight against rheumatoid arthritis requires strikes "on all fronts which means that without proper nutrition medicines will not be so effective, and physiotherapy will not help improve the condition of the joints without gymnastics.

Modern treatment of rheumatoid arthritis is aimed at achieving several goals:

  • elimination of the root cause (not in all cases it will be possible);
  • reduction, and, ideally, elimination, of symptoms;
  • prevention of destruction and deformation of joints;
  • achievement of a stable remission.

For these purposes, a course of medications is prescribed. In the treatment of rheumatoid arthritis apply:

  • non-steroidal anti-inflammatory drugs (reduce inflammation, reduce pain, but do not affect destructive changes in joints);
  • basic medicines in combination with hormonal drugs (help to reduce the activity of pathology development);
  • regulators of differentiation of lymphocytes - they help to prevent damage to the synovium by lymphocytes, which immunity directs to "attack" joints;
  • glucocorticoids - effectively eliminate pain syndrome;
  • drugs for the suppression of immunity, which do not allow the creation of new foci of inflammation.

It should be remembered that all medicines have contraindications and can cause side effects. For example, non-steroids are very carefully prescribed for gastritis.

That's why only a doctor can choose a medicine.

Self-medication always leads to sad consequences,exacerbating the condition of the joints so much that a person turns out to be disabled.

Only after the inflammation is eliminated and the disease passes the stage of the acute course physiotherapy procedures are prescribed.

Recall that heating is prohibited in inflammation, therefore, warming procedures are prescribed only with absolute certainty that there is no inflammatory process in the body.

In parallel with the beginning of drug treatment, the patient is encouraged to adjust the diet to help stabilize the metabolic processes occurring in the body.

The scheme of healthy eating is classical - excluding everything from the diet that affects the deposition of fat, can disrupt metabolism, cause allergies or give greater burden to the kidneys and gastrointestinal tract.

This includes the rejection of bad habits - alcohol, smoking.

Unfortunately, cases where all types of treatment are unable to stop the destructive power of rheumatoid arthritis are not uncommon. In this case it is necessary to resort to a surgical operation.

Most often, a synovectomy is performed on the knee joint, during which the synovial membrane of the joint is removed.

In severe cases, a strongly deformed joint is replaced with a prosthesis (most often endoprosthetics is performed on the knees and hip joint).

It will be useful to learn about the prevention of rheumatoid arthritis and the fact that he did not encounter this patient, but the doctor himself recommends after adherence to the treatment certain rules.

  • Follow the diet, making the diet complete, including enrich it with products containing calcium and vitamin C.
  • To refuse from bad habits.
  • Regularly undergo examination of the joints, including a general blood test for the detection of rheumatoid factor. Doing this after 50 years is necessary every year.
  • Pass sanatorium-and-spa treatment in specialized institutions that specialize in various types of arthritis.
  • Daily exercise exercises, giving joints and muscles commensurate with the age of the load.
  • Protect joints from hypothermia and trauma, as well as excessive physical exertion.
  • Do not leave untreated infectious diseases, because even ordinary flu can articles cause rheumatoid arthritis.

Harsh statistics show thatRheumatoid arthritis with frequent exacerbations shortens life on average by 7 years, so if you want to live a long and full life, be attentive to your body and do not hesitate to seek medical help in a timely manner.

A source: https://medeok.ru/artrit/revmatoidnyy-artrit-simptomy-i-lechenie