Polyarthritis( rheumatoid arthritis) symptoms
Polyarthritis( rheumatoid arthritis) is a chronic inflammatory disease with joint damage and progressive deformation, sometimes changing other organs. A fairly common systemic disease that can cause joint inflammation throughout the body. Joints contain many structures that make movements free. The ends of the bones in the joint are protected from rubbing against each other by an elastic interlayer called cartilage. The entire joint is surrounded by a capsule called the synovial bag. A thin layer of tissue( synovial membrane) lining the bag and secrete a synovial fluid that provides lubrication to facilitate movement.
Recent research suggests that rheumatoid arthritis is an autoimmune disease caused by an attack of the immune system on some of the body cells. When a disease is detected, a number of autoimmune disorders, in particular the so-called rheumatoid factor. The disease usually develops between the ages of 20 to 50 years, and its probability increases with age. Women suffer from it approximately three times more often than men. Treatment is aimed at reducing pain and inflammation, preventing deformity of the joints and maintaining their functioning. How to treat this ailment with folk remedies, look here.
• Early symptoms that precede joint disease: fatigue and weakness;slightly elevated temperature;general feeling of poor health;loss of appetite and weight. At an early stage of rheumatoid arthritis, the synovial membrane becomes inflamed and thickens, causing pain and restricting the movement of the joint. As the disease develops, the cartilage and ends of the bones are destroyed. As a result, the joints are severely damaged and deformed. Pain in joints is often preceded by general, nonspecific symptoms: fever, fatigue and loss of appetite. Before the onset of pain, joint stiffness may also be observed, especially in the morning.
• Red, swollen, painful joints that can be warm to the touch. With prolonged rheumatoid arthritis joints can become curved and crooked. An important sign of the disease is pain, swelling, redness and fever in the small joints of the hands and wrists. The process can also cover elbows, shoulders, knees, hips, ankles, legs and neck. Symptoms usually occur symmetrically, that is, the joints on both sides of the body are usually affected at one time. In some cases, other organ systems, including the eyes, heart and lungs, can also become inflamed.
• Stiffness, especially after waking up in the morning( this symptom often occurs with repeated exacerbations of the disease).
Symptoms occur in the form of long-lasting seizures that can alternate between periods of disease relaxation with a decrease or a complete absence of pain and stiffness.
• Red, painless thickening on the skin, known as rheumatoid nodules, on the elbows, knees or toes.
• Chest pain and difficulty breathing.
• Dry mouth and dry, painful eyes.
Sometimes there are only minor changes in joints with mild inflammation and moderate deformity, without significant progression. In other cases, there are repeated prolonged exacerbations of the disease, which can begin with the lesion of one joint, but quickly lead to deformation of many joints. The defeat of small joints of the extremities with thickening of proximal interphalangeal articulations, wrist joints, ankylosis and typical ulnar deviation of the hand, involvement of other joints of the extremities, spine, and jaws is characteristic. In the period of exacerbation, swelling, redness of the joints, tenderness in movement and palpation are determined. Sometimes the disease progresses without pronounced exacerbations with increasing gradual deformation of the joints. An important symptom of the disease is a feeling of morning stiffness in the joints. Gradually, due to impaired movement, muscle atrophy occurs. At the X-ray examination, there is a slight depression of the bone tissue at first, a narrowing of interarticular cracks, subluxation, and marked osteoporosis appear later.
Sometimes, especially in younger individuals, there is a systemic lesion: in addition to arthritis, there is an increase in lymph nodes, spleen, liver, changes in the kidneys( development of jade or amyloidosis), serositis( pleurisy, pericarditis).Possible defeat of the heart with the development of insufficiency of the mitral or aortic valve.
Changes in the body's reactivity in rheumatoid arthritis can be due to various factors, in particular hypothermia, mental or physical trauma, infection, but the latter is usually not significant in the development of the disease.
• The cause of rheumatoid arthritis is unknown.
• Genetic factors play a role.
• Outbreaks of rheumatoid arthritis can be caused by emotional stress or other illness.
The inflammatory process in rheumatoid arthritis is characterized by fever, increased ESR, leukocytosis, shifts of protein fractions. Diagnostic value is the definition of the so-called rheumatoid factor( positive reaction of Vaaler-Rose, latex test, dermatol assay).The dynamics of these indicators is also important for assessing the effectiveness of treatment.
• Case history and physical examination. There is no special analysis to determine rheumatoid arthritis;long-term observation of changes in joints may be necessary to establish a final diagnosis.
• Blood tests for autoimmune rheumatoid factors;almost half of the patients may have anemia.
• X-ray of the affected joints.
• Synovial fluid analysis. Under local anesthesia, the synovial fluid is taken from the affected joint.
When the disease worsens, butadion is prescribed 0.15 g 3-4 times a day, acetylsalicylic acid 1 g 3-4 times a day. Instead of butadione, indomethacin can be used at 0.025 g 3-6 times a day. With pronounced signs of inflammation and defeat of internal organs, prednisolone( 15-20 mg / day) is shown, in severe cases - in combination with immunosuppressants( azathioprine, cyclophosphamide 100-150 mg / day).
• To reduce fever and pain, the doctor can prescribe large doses of aspirin or one of many other non-steroidal anti-inflammatory drugs, for example, ibuprofen, naproxen, nabumethon, salsalate or cyclooxygenase-2 inhibitors( a new class of over-the-counter anti-inflammatory drugs that reduce pain andinflammation with a lower risk of bleeding or stomach ulcers, which are common side effects of other over-the-counter anti-inflammatory drugs).
• The current trend in the treatment of rheumatoid arthritis is the faster transfer of patients to other, stronger antirheumatic drugs if the initial anti-inflammatory drugs do not cope with the symptoms.
• Due to possible side effects, patients receiving this therapy should be supervised by a physician.
• Hydroxychloroquine, a drug that is usually given with malaria, can also be used to relieve the symptoms of rheumatoid arthritis. The effect of the drug is observed no earlier than three to six months.
• Solutions containing gold salts can be taken orally or by injection to reduce inflammation and pain.
• Methotrexate, an antimetabolite drug, can be prescribed to monitor the immune system. If symptoms persist, you can try to take immunosuppressants.
• Sulfasalazine has an effect by suppressing the response of the immune system, which becomes active in rheumatoid arthritis, and also has an anti-inflammatory effect.
• The antibiotic minocycline acts more as an anti-inflammatory drug;it has a moderate effect on patients in the early stages of the disease.
• Oral corticosteroids such as prednisone quickly relieve the symptoms of rheumatoid arthritis. Since long-term administration of prednisone has strong side effects, it is often given only with acute outbreaks of the disease or when other treatments are ineffective. The introduction of corticosteroids into the affected joint can also bring relief.
• Drugs designed to manage the mechanisms of disease development are being developed;perhaps they will be able to prevent damage to the joint. Newly developed progressive treatments include: leflunomide, an immunomodulator that has an antiproliferative, as well as anti-inflammatory effect;ethanercept and inflix-simab, which suppress the tumor necrosis factor - a substance that is produced in excessive amounts in patients with rheumatoid arthritis.
• Hot or cold compresses can relieve pain.
• People with rheumatoid arthritis often need more than 10 hours of sleep at night or in an eight-hour sleep at night and two hours of daytime sleep.
• Capsaicin-containing creams or lotions can be used to reduce minor joint pain. Means containing camphor, menthol or turpentine, can ease pain and mild symptoms.
• Contrary to popular belief, there is no evidence that bee venom weakens or cures rheumatoid arthritis.
• Tires can be used to reduce pain by immobilizing joints in severe seizures.
• A doctor can prescribe an exercise program or advise you to visit a physiotherapist. Because too vigorous exercise can worsen symptoms, such programs include exercises that can be performed to increase the range of motion of the joints.
• Some exercises are easier to perform in the pool or in a hot tub, as water helps maintain the body;These exercises should be discussed with your doctor or physiotherapist.
• Surgery to remove the affected synovial membrane from the affected joint may be required if the disease develops strongly.
• The operation to remove the damaged joint and replace it with a mechanical joint( arthroplasty) can be performed in serious cases. Almost 90 percent of the 150,000 joint replacement operations occur in the hip or knee joints, but shoulder and elbow joints, joints of the hands and feet can also be replaced. Discussion of the movements that the patient would like to perform after joint replacement helps the surgeon to choose a suitable prosthesis and technique of its implantation, and the patient learns more about the risks and limitations of the operation.
• There is no known way to prevent rheumatoid arthritis.
For the prevention of exacerbation of the disease, quinoline preparations( resorchin, delagil 0.25 g once a day) are prescribed. Through 1,5 2 months do a break in treatment for 10 14 days in order to avoid complications from the eyes( opacity of the cornea).In severe lesions of one or two large joints, intraarticular administration of hydrocortisone( 50-100 mg) is indicated. If ankylosis occurs, surgical treatment is possible.
Exacerbations require therapeutic gymnastics, physiotherapy, massage, spa treatment( Tskhaltubo, Matsesta).
To prevent disease, timely treatment of chronic foci of infection( eg, carious teeth) is of some importance.
Consult a doctor if joint pain interferes with normal operations.
The disease can last for years and decades, sometimes leading to immobility of the patient. The prognosis significantly worsens with kidney amyloidosis, which can lead to the development of chronic kidney failure.