Pathogenesis (disease development) Rheumatoid arthritis (RA) involves the immigration of inflammatory cells – macrophages and T lymphocytes – into the synovial membrane (inner lining of the joint capsule) and the release of proinflammatory (inflammation-promoting) cytokines such as interleukin-1b and TNF-α – tumor necrosis factor alpha – which contribute significantly to joint destruction. It is not … Rheumatoid Arthritis: Causes
General measures Nicotine restriction* (abstaining from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Limited caffeine consumption (max 240 mg of caffeine per day; equivalent to 2 to 3 cups of coffee or 4 to 6 cups of green/black tea). Aim for normal weight* … Rheumatoid Arthritis: Therapy
The following are the most important diseases or complications that may be contributed to by rheumatoid arthritis: Respiratory system (J00-J99) Chronic obstructive pulmonary disease (COPD). Kaplan syndrome – unclear combination of pulmonary fibrosis and pneumoconiosis (lung disease due to exposure to dusts). Pulmonary fibrosis – connective tissue remodeling of lung tissue. Pleurisy (pleurisy) Pneumonitis – … Rheumatoid Arthritis: Secondary Diseases
ACR/EULAR (American College of Rheumatology, EULAR = European League Against Rheumatism) classification criteria for rheumatoid arthritis (RA). Stage Description Score A Joint involvement (synovitis/inflammation of the synovial membrane) 1 large joint1 0 2-10 large joints 1 1-3 small joints2 (with/without involvement of large joints). 2 4-10 Small joints (with/without involvement of large joints). 3 > … Rheumatoid Arthritis: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing) [It is typical of rheumatoid arthritis that the specific joint symptoms are symmetrical (bilateral). However, in about one-third of patients, symptoms may initially be limited to … Rheumatoid Arthritis: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Differential blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate): CRP is a biomarker for diagnosis and at the same time for evaluation of disease activity of rheumatoid arthritis [mildly to moderately elevated CRP levels] CRP may play an important … Rheumatoid Arthritis: Test and Diagnosis
Therapy goals Remission (temporary or permanent remission of disease symptoms) of rheumatoid arthritis (RA). Prevention or slowing of the destruction (“destruction”) of the affected joints. Therapy recommendations The overriding principle of therapy is that decisions are made together with the patient (shared decision). Therapy escalation if the therapy goal is not achieved only after 3 … Rheumatoid Arthritis: Drug Therapy
Obligatory medical device diagnostics. Radiographs of affected joints (method of choice); not appropriate in the early phase of the disease; radiographic signs include: Symmetrical, often polyarticular involvement. Concentric joint space extension Erosions due to bone destruction (destruction of bone tissue). Secondary arthroses Ankyloses (stiffening of joints) Subchondral cysts Ulnar deviation/deformities of the fingers (swan neck/buttonhole … Rheumatoid Arthritis: Diagnostic Tests
Within the framework of micronutrient medicine (vital substances), the following vital substances (micronutrients) are used to prevent rheumatoid arthritis: Vitamins C and E Trace elements selenium, copper, iron, zinc In the context of micronutrient medicine (vital substances), the following vital substances (micronutrients) are used for supportive therapy: Omega-3 fatty acids docosahexaenoic acid and eicosapentaenoic acid. … Rheumatoid Arthritis: Micronutrient Therapy
It is possible to perform both prophylactic (preventive) and reconstructive (restorative) surgery: Synovectomy: A synovectomy involves the complete removal of the diseased synovium of a joint (articulosynovectomy) or the tendon sheaths (tenosynovectomy). The operation can be performed in the early stages of the disease to delay the destruction of the joint, but also in the … Rheumatoid Arthritis: Surgical Therapy
To prevent rheumatoid arthritis, attention must be paid to reducing individual risk factors.Behavioral risk factors Diet High intake of the omega-6 fatty acid arachidonic acid (animal foods such as pork and pork products and tuna). Low intake of long-chain polyunsaturated fatty acids (PUFA); regular consumption of one fish meal per week compared to no fish … Rheumatoid Arthritis: Prevention
Rheumatoid arthritis begins insidiously in about two-thirds of patients with flu-like symptoms such as: Fatigue Weakness Anorexia (loss of appetite) General feeling of illness Notice. These symptoms may prevail for weeks to months, delaying diagnosis. Rheumatoid arthritis begins acutely in only about 10 percent of patients, with rapid onset of polyarthritis (arthritis of ≥ 5 … Rheumatoid Arthritis: Symptoms, Complaints, Signs
