13 May 2019
Rheumatoid arthritis is an inflammatory rheumatism that usually affects the joints of the hands, wrists and knees but can reach the neck, shoulders, hips and ankles.
This pathology is accompanied by pain and can evolve to deformations of these joints. This form of joint inflammation affects adults starting around 45 to 50 years.
More details to better understand
The joint includes a cartilage and a synovial membrane that wraps the tendons and ligaments to support them at the ends of the bones. Inflammation of synovial membrane called synovitis leads to its thickening because of its infiltration by inflammatory cells (dendritic cells, monocytes, lymphocytes, macrophages ...) These cells will attack the cartilage, bone, ligaments and tendons and can destroy them. We are then faced with an autoimmune disease.
Many factors are involved, such as, heredity, viral or bacterial infections, tobacco, emotional shocks and hormonal factors (in women, this pathology often appears after menopause).
The first symptoms
In its first phase, rheumatoid arthritis (RA) is manifested by joint pain and edema (swelling), which is sometimes accompanied by local heat and redness. The joints are stiff, especially in the morning or after a long period of inactivity requiring relaxed movements to stretch them. These symptoms are symmetrical; they appear at the joints of the body on both sides.
The evolution of the disease
From the first symptoms, it is necessary to consult a physician specialist in rheumatology. An early diagnosis and management avoids the constraining and disabling evolution of this pathology.
During this phase, and with persistent pain, small painless bumps (pannus) form under the skin at the joints. As they evolve there will be motion difficulty due to joint deformations. This inflammation will reach other joints and become disabling for the patient who may have a depressive syndrome.
Diagnosis and exploration
To avoid the complications of this disease, follow the instructions of the rheumatologist who will follow after auscultation and interrogation to an exploration by biological analyzes (CRP, VS, rheumatoid factor, ACPA) and prescribe radiological examinations (X-ray of affected organs). An MRI and an ultrasound are sometimes requested.
Treatments
Rheumatoid arthritis evolves into relapses. The first symptoms are treated with painkillers and anti-inflammatories. These are corticosteroids that are prescribed in these cases because they are more effective, except that they require a lot of precautions (low sodium diet, monitoring of blood pressure ...).
The clinician uses corticosteroid injections at the joints for advanced cases.
Background therapy requires the administration of immunosuppressive agents (except during pregnancy). According to the evolution of this pathology, these treatments are associated with physiotherapy and occupational therapy. The medical management of rheumatoid arthritis aims to alleviate the ailments and invasive spread of inflammation and to prevent damage to the bone and ligaments. It also aims to improve the quality of life of the patient through psychological care.
