Rheumatoid arthritis is a chronic disease that affects several body systems and whose cause is still unknown. This disease affects the joints especially in producing a chronic inflammation which causes pain, stiffness, swelling and loss of mobility of the body.
It is an autoimmune disease where the immune system attacks parts of the body especially the joints because it recognizes as its own and therefore this inflammation occurs.
Rheumatoid arthritis affects especially women being the most common age of onset is between 20 and 45 years. Approximately two-thirds of people who suffer from this disease begins insidiously in a form of fatigue, loss of appetite, weakness generalized and nonspecific musculoskeletal symptoms, which makes it very difficult to diagnose.
There is a 10% of those affected where the disease onset may be sudden with pain and swelling of various joints particularly the hands, feet, wrists, elbows and ankles although any joint may be compromised in which it usually is accompanied by fever, swollen lymph nodes and spleen enlargement.
Rheumatoid arthritis usually affects the joints of the hands, feet, wrists, elbows and ankles. More frequently observed in the beginning is a more or less slow and progressive accompanied by joint pain inflammation and joint stiffness especially when you get up in the morning and for a duration which is usually higher to an hour. It can also be accompanied by malaise, weakness, fever and passes as fatigue.It may take months or years before changes like joints deformities that could lead to movement limitations.
Although the most characteristic in the joint involved may be affected many other body structures:
- Rheumatoid nodules: They are hard skin lumps or nodules that appear in friction areas such as elbows, backs of the fingers and toes, the back of the head and the heel area.
- Jorgen’s syndrome Rheumatoid arthritis can cause inflammation and atrophy of the glands that produce tears, saliva, digestive juices or vaginal fluid resulting in dry eyes, lack of salivation and taste disturbance behaving along with the lack of saliva and gastric juice secretion that hinders proper digestion.
- Ocular: Conjunctivitis and episcleritis among others.
- Vasculitis: Inflammation of the arteries and veins, with consequent formation of skin ulcersaround the nails or chilblains and heart attacks.
- Neuritis: involvement and commitment of the nerves, which in the case of rheumatoid arthritis is localized mainly at the level of the median nerve which can be compressed at the wrist due to inflammation of the annular ligament. This results in a sensation of numbness at hand level. Other changes may be sweating and coldness of extremities and changes at the level of the skin, nails, and hair, which are due to nerve involvement of the autonomic system.
- Cardiac involvement: In the most common heart involvement usually at the membrane encasing the pericardium and appears due to an increase inflammation. Other cardiac structures that may be affected are the heart valves, especially the aortic valve, inflicting on murmurs and may facilitate long-term presence of either cerebral embolism or limb level.
- Pulmonary involvement: Rheumatoid arthritis can also affect the lungs, both overlying membrane, pleura with increased production of pleural fluid that results topleurisy pain although only a small number of these patients presented pleural effusion. It can also be affected and diffuse the lung presenting a dry cough that occasionally accompanies breathlessness.
How is it diagnosed?
To find out if a person has rheumatoid arthritis, the physician assesses the symptoms described above. However, there are many other rheumatic diseases that can cause similar discomfort. For this reason the findings that can be found on radiographs and analytical studies on rheumatoid factor are useful to confirm the diagnosis, although there is no specific test for the diagnosis of rheumatoid arthritis. It may happen that a person’s pain and soreness in the joints for some time and that neither the intensity of their illness, or X-rays or tests thatallow doctors to make the diagnosis with certainty.