Rheumatoid arthritis is one of the severest and most crippling of the arthritic disorders. It is an aggressive disease which, although the exact cause still remains a mystery, is often linked with other autoimmune disorders where the body appears to attack itself.
The joint surfaces are protected by cartilage, which is lubricated by secretions produced in the Synovium, the linings of the joint and it is this tissue that is attacked. Eventually the joint protection provided by the cartilage becomes so distorted and destroyed that the joints themselves also become victims. The results of this can more easily be seen in the hands and feet where the fingers or toes can be displaced to one side. Other areas often affected are the knees, hips, shoulders and elbows.
Associated with this condition is a general feeling of malaise. The condition produces characteristic pain and stiffness that is worse in the morning and will last for several hours.
Sometimes skin nodules or rashes can be seen. This must not be confused with the nodules (Heberden's Nodes) which can appear on the distal joints of the fingers, these are associated with Osteoarthritic changes and are benign and pain free. The pain and joint problem is nearly always bilateral unlike other forms of arthritis, and can be confirmed by a blood test where there is always the presence of a positive rheumatoid factor.
Treatment varies as does the course of this disorder, but generally long term anti-inflammatory drugs are the first course of action. Sometimes Gold injections are used, and other more powerful drugs where careful monitoring has to be carried out.
Physiotherapy has proved highly beneficial in encouraging the patient to keep mobile, however it can be a very aggressive disease, with surges of decline. Splints and supports for joints are also very helpful, especially for the hand and wrists, to allow the sufferer to continue with some independence.
In some cases it is possible to replace severely destroyed joints of the hand, for example, with artificial joints. Various gadgets have been produced to enable those with severe disabilities the opportunity to be self sufficient to a degree, as the condition causes weakness as well as pain.
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