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RA

Rheumatoid arthritis (in English: Rheumatoid arthritis, abbreviated as RA), is an autoimmune disorder caused by the immune system to attack the long-term chronic inflammation of joints. This inflammation can cause joint deformity until the disability, and will wear due to joint pain and loss of some of their activities.

This disease will also have a systematic affect other joints and outside organizations, including the skin, blood vessels, heart, lung and muscle and so on.

Its symptoms are many different joints at the same time so that soft-tissue swelling pain inflammation (polyarthritis). Of the affected joints at the beginning is asymmetric, in the patient's condition will gradually become symmetrical development. Joint pain with joint movement will be improved, in the morning, joints will be hard for about an hour. Thus, rheumatoid arthritis, pain due to arthritis in the morning and the pain will be worse than others.

Patient's condition will continue to develop to the articular surface erosion and damage, resulting in limb deformity. Fingers will generally tend to the little finger (the ulnar bending), and was not a natural shape. Rheumatoid arthritis is a typical button deformity deformity (ie, the joints between the proximal phalanx and distal phalanx of excessive flexion excessive stretch between the joints), swan-neck deformity (proximal phalanx between the distal joints of the over-extension and excessive inter-phalangeal joint flexion). Thumb may be developed into a Z-shaped deformity of thumb that the fixity of metacarpophalangeal joint flexion and joint displacement, so that the formation of a square-shaped hands.

Extra-articular effects is another difference with osteoarthritis, rheumatoid arthritis, it is a multi-system disease. As the majority of patients suffering from this disease will also suffer from anemia, which is itself a result of the impact of rheumatoid arthritis (chronic disease, anemia), or the use of drugs (especially for non-steroid anesthetic anti-inflammatory analgesics) in the treatment of gastrointestinal bleeding, when all the side effects. Splenomegaly and leucopenia also appear together (known as Felty syndrome), and lymphocytes also affect the salivary glands and lacrimal gland immersion (known as Sjogren's syndrome).

Here are some of the impact of the system will be affected by rheumatoid arthritis:

Skin: In the extensor surfaces, such as the elbow with rheumatoid nodules occur.
Lungs: lung may be directly affected by the impact of arthritis, or affected by the impact of treatment. After treatment (eg, methotrexate) may appear fibrosis.
Autoimmune: edge neurological disorders, a pleated vascular infarction, neuropathy and nephropathy.
Kidney: amyloidosis also cause pseudo-muscle hypertrophy.
Cardiovascular: heart bursitis, inflammation and fibrosis valve.
Eyes: Dry eye syndrome, inflammation and the sclera sclera surface softening disease, would also lead to eye, cracks and leakage.
Nerve: Most single-neuritis and atlantoaxial subluxation symptoms. The latter is a result of the cervical spine and the skull or the lateral ligament of the odontoid process of erosion, such erosion (greater than 3 mm) will lead to displacement and persecution spinal vertebrae. In the beginning, the patient will feel awkward, if failing to meet the appropriate treatment, will develop into a Paralytic limbs.

With 35-50 years of age are suffering from rheumatoid arthritis, the largest family history will be an important factor in the pathogenesis. It is with the human leukocyte antigen HLA-DR4 has a correlation (W4, W14 and W15 with this disease related to the W10 and W13 are protective).

The incidence of rheumatoid arthritis per 10,000 population, there are 30 cases. Opportunities for women, the incidence is three times more men to 5 times, while the incidence of the opportunity may be non-smokers smokers 4 times. Prevalence rate of about 1%, and some Indians, the prevalence rate of 5-6%, while the Caribbean Sea has fewer blacks were the prevalence of. First-degree relatives of patients the prevalence of 2-3%, while the monozygotic twins with the prevalence rate is 15-20%.

American College of Rheumatology in 1987, the definition of the following conditions as rheumatoid arthritis [1]:

More than 1 hour of morning stiffness;
3 or more inflammation of the joints;
Metacarpal, wrist and proximal interphalangeal joints such as arthritis occurs;
Symmetric arthritis;
Rheumatoid nodule;
Rheumatoid factor positive;
Radiology (X-ray) are detected in articular erosion (erosion).
To achieve at least as long as any of the above four cases, he was judged to be suffering from rheumatoid arthritis. But in suffering from this disease early, some of the above situation is not clear why some patients are not up to it a standard. The purpose is to learn the patients classified as research, rather than help diagnose this disease. If one is wear and tear on joints, in the treatment is mainly to avoid this situation, due to joint wear and tear can not be cured. Therefore, even if the patient did not fully meet the above criteria, will also be treated as suffering from this disease make treatment in order to avoid deterioration of the disease. Nevertheless, this standard is still very useful in research, especially in epidemiology.

The incidence of rheumatoid arthritis per 10,000 population, there are 30 cases. Opportunities for women, the incidence is three times more men to 5 times, while the incidence of the opportunity may be non-smokers smokers 4 times. Prevalence rate of about 1%, and some Indians, the prevalence rate of 5-6%, while the Caribbean Sea has fewer blacks were the prevalence of. First-degree relatives of patients the prevalence of 2-3%, while the monozygotic twins with the prevalence rate is 15-20%.

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American College of Rheumatology in 1987, the definition of the following conditions as rheumatoid arthritis [1]:

More than 1 hour of morning stiffness;
3 or more inflammation of the joints;
Metacarpal, wrist and proximal interphalangeal joints such as arthritis occurs;
Symmetric arthritis;
Rheumatoid nodule;
Rheumatoid factor positive;
Radiology (X-ray) are detected in articular erosion (erosion).
To achieve at least as long as any of the above four cases, he was judged to be suffering from rheumatoid arthritis. But in suffering from this disease early, some of the above situation is not clear why some patients are not up to it a standard. The purpose is to learn the patients classified as research, rather than help diagnose this disease. If one is wear and tear on joints, in the treatment is mainly to avoid this situation, due to joint wear and tear can not be cured. Therefore, even if the patient did not fully meet the above criteria, will also be treated as suffering from this disease make treatment in order to avoid deterioration of the disease. Nevertheless, this standard is still very useful in research, especially in epidemiology.


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