Rheumatoid arthritis is a recurrent pathology of an inflammatory nature that affects the connective and cartilage tissue of the joints. The disease most often begins after a sore throat, acute respiratory viral infection against the background of defective treatment of infections. A prolonged inflammatory process leads to a pronounced restriction of movements in the joints and to severe pain. Treatment of patients with rheumatoid arthritis should be started as early as possible, this will significantly reduce the risk of consequences that may cause disability.polyarthritis
Causes of the disease
A single cause of the disease has not been established. However, most scientists believe that rheumatoid arthritis occurs as a result of beta-hemolytic streptococcus. The pathogenic microorganism most often causes infections of the upper respiratory tract – pharyngitis, tonsillitis, scarlet fever. With timely and adequate treatment, that is, the use of antibiotics, symptomatic therapy and bed rest, bacteria die and do not spread throughout organisms.
Otherwise, special immune complexes are formed that gradually affect the connective tissues, including articular. Naturally, the lesion process is not characteristic of all patients with angina or pharyngitis. A number of factors provoking pathology predispose to it, these are:
- Predisposition at the genetic level expressed in the slight resistance of musculoskeletal structures to the effects of autoimmune processes;
- Joint injuries;
- The presence in the body of a focus of chronic infection, for example, carious teeth;
- Endocrine disruption;
- Significant deterioration in the functioning of the immune system. Pathology often occurs in those who suffer from SARS more than 3-5 times a year;
- Hypothermia of the body.
Pathology usually first occurs in fairly young people aged 17 to 45 years.polyarthritis
Symptoms of the disease
The main symptoms of rheumatoid arthritis usually begin to disturb for the first time 2-3 weeks after an infection of the ENT organs. The disease begins abruptly and is accompanied by:
- Raising the temperature to 38.5-40 degrees;
- Swelling of the affected joints and redness of the skin above them;
- Severe pains.
The intensity of the pain is such that the patient can scream at the time of the attack and lose consciousness. A characteristic feature is the volatility of pain, that is, at first they can be localized in some joints, and after 2-3 days go to others. With it, large joints are usually affected – elbow, knee, cervical, less often small ones. Their function is seriously impaired, which significantly limits movement.
The acute phase takes 2-3 weeks, after which the symptoms disappear almost completely, and the patient considers himself completely healthy. But this is the main mistake – the immune complexes in the body remain and are activated under the influence of provoking factors, which leads to a relapse of the disease.
Over time, the destruction of connective and cartilage tissue worsens the joint and the patient begin to periodically during exacerbations or constantly disturb symptoms such as:
- Swelling and stiffness in the morning. After warming up or closer to dinner, the stiffness goes away. This symptom is considered one of the most reliable signs of the disease;
- Formation of a painful protrusion over the affected joint;
- Pain, which in advanced cases can bother almost constantly;
- Restriction of movements.
In some cases, the symptoms of developing rheumatoid arthritis are somewhat different from the typical course of the pathology. This also applies to nodular inflammation. This form of the disease is accompanied by the appearance of well-palpable nodules over joints in the thickness of the skin, which can periodically dissolve on their own and reappear.
The difference between the disease and similar pathologies
Rheumatoid arthritis should not be confused with rheumatoid arthritis in the first place. Despite all the similarities of the clinical signs of these two diseases, they have significant differences, allowing you to put the correct diagnosis and, accordingly, choose a competent treatment regimen.
Table of differences
|Type of disease||Secondary disease developing as a complication of an infection||Autoimmune pathology|
|Symptom Rate||It develops rapidly, accompanied by fever and acute pain.||The disease progresses slowly, moderate pain|
|Etiology||In most cases, it occurs after the inflammatory processes in the ENT organs.||At the heart of development are autoimmune disorders|
|Possible complications||Damage to the heart, kidneys, respiratory system||There is a restriction of movements in the joints, their gradual deformation|
|Lesion localization||Large joints – knee, elbow, hip, shoulder||Small joints – phalanges of fingers, wrists|
|Forecast||Favorable. With timely treatment, a complete recovery is possible.||Full recovery of the patient is almost impossible. Early treatment prevents deformation.|
Rheumatoid polyarthritis often develops against the background of psychoemotional stress. A provoking cause may be a prolonged shortage of essential trace elements and vitamins in the body, and heavy physical labor. In women, a severe pregnancy, repeated abortions can provoke the disease.
The progression of rheumatoid polyarthritis can take from several months to several years. In the most favorable cases, severe atrophy does not occur, so the patient does not experience almost any serious problems. To achieve this course of the disease, you need to start its treatment as early as possible.
The treatment of a patient with joint pain begins with a thorough diagnosis. The doctor must visually assess the nature of the changes, conduct a survey during which complaints, previous illnesses or injuries, a history of life are clarified. The alleged diagnosis is confirmed or disproved by diagnostic procedures.
If you suspect this disease, the patient is prescribed:
- Blood tests. In the general analysis, during an exacerbation, ESR and the number of leukocytes will be sharply increased. In biochemistry, the number of antistreptolysins increases, antistreptococcal antibodies are detected;
- Analysis of urine. The appearance of protein is possible, which indicates kidney damage;
- Roentgenography. In contrast to rheumatoid polyarthritis, there are no significant changes in the images with the rheumatic nature of the pathology. It is possible only the expansion of the joint space due to the accumulation of exudate in the inflammatory process;
- Ultrasound It is prescribed to detect changes in internal organs, including the heart;
- MRI and CT. These studies with reactive arthritis are uninformative, they show only the focus of inflammation.
All research data are evaluated in conjunction with the clinical signs of the disease. Symptoms reliably indicate rheumatoid arthritis such as:
- The acute onset of the disease after suffering a sore throat or SARS;
- The defeat of mainly large joints;
- Symmetry of the inflammatory process;
- Migratory pains;
- No deformation of joints.
Rheumatoid arthritis disappears within a month and even if untreated. However, therapy is essential for the patient. Properly selected medications reduce the intensity of pain, make you feel better and prevent the development of unwanted changes.polyarthritis
Treatment will be effective only if the patient receives the correct medication. The main goals of therapeutic measures are:
- Anesthesia, which allows adequate relief of pain;
- Decrease in inflammatory processes;
- Reduction of puffiness;
- Symptomatic Therapy
Properly selected drugs and compliance with the recommendations of a doctor can significantly reduce the risk of exacerbations in the future.
Strong painkillers are necessary only in the acute phase of rheumatoid arthritis or if relapse is prolonged. Often, pain in a patient disappears only after using drugs – Morphine, Promedol, Tramadol.
From other medications prescribed:
- Nonsteroidal anti-inflammatory drugs – Nimesulide, Dexketoprofen, Ketoprofen. Medicines from this group relieve inflammation, reduce swelling and thus not only reduce pain, but also improve the mobility of the affected joints. They are usually prescribed in tablets or capsules, but with oral intolerance, NSAIDs can be used in the form of rectal suppositories or in injections. Ointments from this group are used topically. With their help, you can slightly reduce pain and improve movement;
- Glucocorticosteroids – Prednisolone, Dexamethasone Injection. Hormones stop the inflammatory process well, but use them only with a short course in the acute phase of the disease. During an exacerbation, hormonal agents are used in situations where other drugs do not help much;
- Antibiotics. They are used to completely destroy the bacteria remaining in the body. Most often, for treatment, patients require Penicillins and Cephalosporins, endowed with a wide spectrum of action.
When signs of heart failure are detected, cardiac glycosides, diuretics, and drugs with vasodilating properties are prescribed. In the acute course of rheumatoid arthritis, effective detoxification is also required, consisting in the introduction of intravenous plasma-replacing drugs and in heavy drinking. Vitamin complexes are prescribed to increase immunity and replenish vital elements.
In the acute phase, the patient is prescribed bed rest. Limiting physical activity reduces joint pain and prevents the spread of pathogenic microorganisms to the heart muscle. Appropriate patient care is also necessary since many of the usual actions for the first two to three weeks of the inflammatory process are difficult. Nutrition should be fortified, easily digestible.
The use of chondroprotectors is advisable if the patient is over 45 years old. In this case, drugs from this group will prevent the occurrence of degenerative-dystrophic changes in the cartilage tissue. During exacerbations, therapeutic gymnastics should not be done, but during the remission stage, it will avoid muscle atrophy. Physiotherapy is prescribed to the patient in order to reduce the inflammatory process and pain.
Surgical intervention involves only the removal of accumulated exudate through a puncture.polyarthritis
Rheumatism and associated polyarthritis can be avoided. In order to prevent the development of pathology, it is necessary:
- Fully treat infections. In the acute course of tonsillitis and pharyngitis, you need to observe bed rest, it is enough to drink fluids in order to remove toxins from the body. Antibiotics must be selected with the attending physician, since the wrong choice of the drug leads to the spread of the inflammatory process, which can cause damage to the joints and cartilage;
- Regularly sanitize the oral cavity, treat caries and gum disease;
- In case of recurrent or protracted infections of ENT organs, conduct a smear examination from the oropharynx for streptococcus.
If an illness has already occurred, try to avoid exacerbations. It will help in strengthening immunity, preventive treatment, prevention of hypothermia. Once every six months, it is necessary to undergo an examination that will allow you to detect unwanted changes in time.
Possible complications and prognosis
With rheumatic damage to the joints, their deformation occurs only as a result of age-related changes in the tissues. But this pathology can lead to damage to the heart muscle, which often ends:
- Myocarditis or endocarditis;
- The formation of valvular heart disease;
- Heart attack.
Pleurisy, renal failure, annular erythema are also possible. Therapy of complications does not always lead to a complete recovery, which can result in heart failure and disability.
The above complications can be avoided only by timely treatment. The doctor’s prescriptions must be fully fulfilled. Drug therapy should be brought to an end. During the treatment period, it is necessary to avoid the development of infectious and inflammatory diseases, hypothermia, increased load on the joints.polyarthritis