Joint abnormalities in rheumatoid arthritis
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Rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. It is a disabling and painful inflammatory condition, which can lead to substantial loss of mobility due to pain and joint destruction. more...

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The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and muscles.

The name is derived from the Greek rheumatos meaning "flowing", the suffix -oid meaning "in the shape of", arthr meaning "joint" and the suffix -itis, a "condition involving inflammation".

Features

Rheumatoid arthritis is a chronic, inflammatory multisystem autoimmune disorder. It commonly affects the joints in a polyarticular manner (polyarthritis). The symptoms that distinguish rheumatoid arthritis from other forms of arthritis are inflammation and soft-tissue swelling of many joints at the same time (polyarthritis). The joints are generally affected in a symmetrical fashion. The pain generally improves with use of the affected joints, and there is usually stiffness of all joints in the morning that lasts over 1 hour. Thus, the pain of rheumatoid arthritis is usually worse in the morning compared to the classic pain of osteoarthritis where the pain worsens over the day as the joints are used.

If the arthritis has been longstanding, the inflammatory activity has led to erosion and destruction of the joint surface, which impairs their range of movement and leads to deformity. The fingers are typically deviated towards the little finger (ulnar deviation) and can assume unnatural shapes. Classical deformities in Rheumatoid arthritis are the Boutonniere deformity (Hyperflexion at the proximal interphalangeal joint with hyperextension at the distal interphalangeal joint), Swan neck deformity (Hyperextension at the proximal interphalangeal joint, hyperflexion at the distal interphalangeal joint). The thumb may develop a "Z-Thumb" deformity with fixed flexion and subluxation at the metacarpophalangeal joint, leading to a "squared" appearance in the hand.

Subcutaneous nodules on extensor surfaces, such as the elbows, are often present.

Extra-articular manifestations also distinguish this disease from osteoarthritis (hence it is a multisystemic disease). Haematological: Most patients also suffer of anemia, either as a consequence of the disease itself (Anaemia of Chronic disease) or as a consequence of gastrointestinal bleeding as a side effect of drugs used in treatment, especially NSAIDs (non-steroidal anti-inflammatory drugs) used for analgesia. Splenomegaly may occur (Felty's syndrome).

Dermatological: Subcutaneous nodules

Pulmonary: The lungs may become involved as a part of the primary disease process or as a consequence of therapy. Fibrosis may occur spontaneously or as a consequence of therapy (for example methotrexate). Caplan's nodules are found as are pulmonary effusions.

Read more at Wikipedia.org


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Rheumatoid arthritis
From Ebony, 7/1/05

Do you have pare in multiple joints? Does the pain occur symmetrically--or do the same joints on both sides of your body hurt at the same time? Or is the pain one-sided? Do you have stiffness in the morning? Do you have pain in your hands, wrists and/or feet?

If you answered yes to any of these questions, you may want to ask your doctor about a condition known as rheumatoid arthritis.

It is a serious, sometimes debilitating, autoimmune inflammatory ailment that affects the joints, hands, wrists and elbows, and according to medical experts, is increasingly affecting African-American men and women.

Diagnosing the disease is difficult, with doctors saying there is no clear-cut way to make a determination. As a result, doctors rely on answers to questions (like those listed above), medical history, physical exams, lab tests and X-rays.

"We're finding that as obesity increases in the Black population, we're finding more rheumatoid arthritis," says Dr. George Edmond Smith, M.Ed., author of Taking Care of Our Own, a family medicine health guide for African-Americans. "And as people live longer, the incidence of rheumatoid arthritis is increasing, particularly in the Black population. We're working hard to find out why."

Some doctors and rheumatologists have begun recommending exercise to patients (under their care) to help reduce pain and increase flexibility, says Dr. Smith, a family practice physician in Louisiana.

The good news is that drug treatments are available to help ease the pain, including nonsteroidal anti-inflammatory drugs, analgesic drugs and disease modifying antirheumatic drugs.

"We're trying to increase health literacy among African-Americans," Dr. Smith says, "so that they will know these treatments are out there. We want them to seek treatment before the disease becomes debilitating."

COPYRIGHT 2005 Johnson Publishing Co.
COPYRIGHT 2005 Gale Group

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