RHEUMATOID ARTHIRITIS
Rheumatoid Arthritis (RA) is one of the most common chronic inflammatory diseases that affects small joints such as hand and foot joints (Figure 1). It sometimes can affect large joints, such as hip and shoulder. The causes of illness are not known but it is thought that some genetic and environmental factors can be effective. RA is mostly diagnosed in middle-aged women but sometimes it can also be seen in older and younger ages.
Figure 1:Involvement of handjoints in rheumatoid arthritis
Clinical Symptoms and Diagnosis of Rheumatoid Arthritis
The illness begins slowly and insidiously. The most important symptom is joint pain and morning stiffness in these patients. The joint pain sometimes prevent these patients from night sleep. Morning stiffness usually lasts longer than 30 minutes. When the patients wake up in the morning, they are painful and their small joints’ movement in hands and foots are limited. In addition to joint pain, swelling, tenderness, increased local temperature in the joints may also be seen.
The diagnosis is made with history, physical examination as well as laboratory tests.
Extraarticularfindings in Rheumatoidarthiritis
The RA can cause systemic symptoms such as weakness, fatigue as well as serious organ damage. For example, the organ involvement may include heart, eye, skin, and lung. Anemia may also be seen.
TREATMENT OF RHEUMATOIDARTHIRITIS
Currently, the aims of RA treatment are to reduce joint pain and inflammation and to prevent joint deformity. Quality of life of patients increases by treatment. Drugs used in the treatment might suppress immune system cells in patients. The biochemical and functional test of liver and kidney and also blood count should be performed every three months as long as they are used.
If pregnancy is planned, some drugs should be stopped before pregnancy. Symptoms of disease may decrease during pregnancy but exacerbation of illness can be seen after pregnancy.
The treatment of RA is planned individually according to the severity of disease, accompanying health problems and, personal characteristics. Rest is the most important part of the treatment. The cold package applying is recommended in the acute period, warm treatment or spa are not convenient in exacerbation period. The exercises arranged by doctors are beneficial during remission period.
To prevent of extremity deformities and to protect of functions of joints can be used some devices called by “splint” (Figure 2).
Figure 2:Handsplints