Rheumatoid arthritis (RA) - chronicinflammatory connective tissue disease of the joints, with frequent pathological process involving internal organs. Rheumatoid arthritis - this is the most common chronic inflammation of the joints.
Women suffer three times more often than men. Disease begins most often in 30-50 years, and the average age of the patients with a diagnosis of "rheumatoid arthritis" is 58 years old. Mortality in this group of patients is 27%. This shows that the effectiveness of the treatment of the disease is very low, and the prognosis remains poor. The most important socio-economic impact of RA - a violation of disability.
Employability can be broken at an earlystages, and it becomes a constant reduction problem, it occurs in 27% of patients during the first 3 years from the start of RA and more than 85% disease duration 8 to 11 years.
The causes of rheumatoid arthritis tonow known accurately enough. In recent years, many experts are inclined to viral theory of the origin of rheumatoid arthritis. It is believed that the disease is still not identified hitherto virus, the action of which leads to malfunction of the immune system and the development of immunopathological reactions. The consequence of these complex processes is the aggression of the immune system against the body's own cells.
Factors predisposing to the development ofrheumatoid arthritis, include genetic predisposition, age over 40 years, female gender, prior allergic skin disease and nasopharyngeal infection.
Most typically a gradual, slow developmentdisease (so-called classic version of course). There are pains, a feeling of stiffness and swelling of joints, most often in the second half of the night and morning. Characteristically feeling stiffness in the joints, more pronounced in the morning. From the very onset of the disease is characterized by symmetric joint damage. For rheumatoid arthritis is also characteristic of early defeat interphalangeal joints.
Approximately 10% of patients with rheumatoid arthritisIt begins and is prolonged in the form one or more lesions of joints, mainly large. Most often it is the knee and wrist, less elbow and ankle joints. Often such patients around the joints can be found subcutaneous nodules rounded, up to 2-3 cm in diameter. The nodules have a dense consistency, painless and often mobile.
In the course of disease and affects internal organs (up to 60% of cases). More often than not "suffer" from the kidneys, which determines the further course and outcome of disease.
A small percentage of patients with RA may begin acutely. High "causeless" fever with chills - the first and most pronounced symptom of this variant of the disease.
Currently, rheumatologists allocate moreseveral clinical variants, but special attention should be juvenile rheumatoid arthritis. He develops more often in girls under the age of 6 years. Usually begins acutely, with the defeat of the large joints, eyes, and the presence of skin rashes.
Given the fact that the disease is chronic, andfactor employee trigger mechanism in the occurrence of this disease is unknown, prevention and treatment of rheumatoid arthritis across a variety of products and high professionalism of our rheumatologists remains a challenge. If you have the above symptoms should not immediately run to the reception to the rheumatologist, refer to the district physician.
After assigning a number of laboratory and possiblyX-ray studies, if necessary, you will get a referral to a rheumatologist. He, in turn, determine the degree of activity of the process, will decide to treat you stationeer or outpatient.
The first thing that you will appoint a physician in the absence ofcontraindications - a non-steroidal anti-inflammatory drugs (NSAIDs) - indomethacin Ortophenum, Voltaren, naproxen, ibuprofen, etc. They cost relatively inexpensive and has at any pharmacy.
It must be remembered that the application of non-steroidalanti-inflammatory drugs may develop gastropathy specific syndrome, which is characterized by lesions of the gastric mucosa (hemorrhage, erosion, ulcers).
Risk factors for the development of gastropathy:
- elderly age;
- previously identified ulcer or gastro - intestinal bleeding;
- concomitant use of glucocorticoids;
- long-term use of NSAIDs in high doses, or concomitant use of drugs in this group of 2-3.
If the inflammation in one or more largejoints clearly expressed, you will probably be asked to enter directly into the joint corticosteroid hormones (hydrocortisone, metipred, kenolog). From this procedure, for that matter, and any other you can refuse. The most effective and commonly used drugs in the treatment of RA are gold salts. Although it is not necessary to wait for the treatment of these miracle drugs quite expensive. The therapeutic effect appears after 3-4 months after initiation of treatment and after discontinuation of the drug is highly likely that the therapeutic effect disappears. Therefore, drugs must be taken continuously.
Today laser used,local radiotherapy and radionuclide therapy (radioactive drug is injected into the joint), a remote local kilocuritherapy (external irradiation of synovial membrane) and surgical treatment of the affected joint.
If there is evidence and a certain amount ofbanknotes of these treatments are available in Petrozavodsk. It should be noted, however, that the treatment "at home" is not much different from "capital", well, except that value.
Beyond acute need daily physicalexercises to preserve joint mobility. Depending on the degree of violation of functions it can be special complexes of medical gymnastics, walking or swimming. Useful warm baths, hydrotherapy.
Selection of a set of physical exercises and physiotherapy conducted by specialists. They are also in particularly difficult cases, provide advice on labor and life of the device.
Diets that prevents the progression of rheumatoid arthritis, no. Power must be complete and balanced, to avoid overeating.
Changes in the joints, characteristic of RA, found in Egyptian mummies (2600 BC). On Rubens paintings depict people with rheumatoid lesions of the hands (1577-1640 gg.).
And they have?
The average cost of hospitalization per patientwith rheumatoid arthritis during the exacerbation of the disease in the US - about 4 thousand dollars. The cost of outpatient care per patient per year - about $ 2,000.