The term “rheumatism” covers a variety of different inflammatory (for example, ankylosing spondylitis) or wear-and-tear-induced joint diseases (for example, osteoarthritis) and soft tissue diseases. In total, about 8 million people in Germany are affected by rheumatic diseases. The word “rheumatism” means flow and denotes the flowing pain that moves from joint to joint through the body. In common usage, “rheumatism” is usually understood to mean rheumatoid arthritis, also known as chronic polyarthritis.
What is rheumatoid arthritis?
Rheumatoid arthritis is a chronic joint disease that leads to destruction and deformation of the affected joints. It is a so-called systemic autoimmune disease. About 1% of the population suffers from rheumatoid arthritis. Women are affected three times more often than men.
The disease usually occurs between the ages of 20 and 50, but it can also affect young children. The disease is not curable. The most important goal of treatment is to alleviate symptoms and prevent progression. The most important measures in this regard are early and careful drug therapy.
Causes unexplained
The cause of rheumatoid arthritis is still unclear. A hereditary predisposition to inflammatory reactions against the body’s own substances seems to play a role. “Rheumatoid factors”, i.e. defense substances against the body’s own factors (autoantibodies), contribute to the disease process. In addition, there is proliferation of the synovium, which surrounds the joint and contains nerves and vessels.
Rheumatoid arthritis: symptoms
Initial symtpoms of rheumatoid arthritis are pain, stiffness of the joints especially in the morning, lack of strength, and swelling of the finger joints on both hands. In one third of those affected, the disease begins atypically, i.e. only a few joints are affected. This is usually accompanied by general complaints such as faintness, weight loss and mild fever.
In 20% of patients, the symptoms of the disease resolve spontaneously. In the vast majority, however, rheumatoid arthritis progresses. “Relapses” occur, which can lead to joint destruction and deformation. Function and strength in the area of the affected joints are limited.
In some cases, other organs (for example, eyes, heart, bone marrow) are also affected by the “inflammation.” Rheumatic nodules” can develop in the skin, lungs and heart. In addition, there are many special forms of rheumatoid arthritis in which particular combinations of symptoms are present that have a particular course.
Effects of rheumatoid arthritis
The main focus of rheumatoid arthritis is pain and destruction of the joint. Deformities and functional limitations are the result. In everyday life, these functional limitations lead to significant disabilities, for example, when walking, dressing, or performing everyday tasks such as opening bottles. Infestation of internal organs can also worsen the quality of life and, in extreme cases, even shorten life expectancy.
How to make the right diagnosis
The most important examinations include physical examination, blood and tissue tests, and X-ray. In most cases, the diagnosis cannot be made right at the beginning of the disease, but only as it progresses, since there are usually only a few typical signs at the beginning. The diagnosis of “rheumatoid arthritis” is made when 7 of the following 10 points are met:
- Morning stiffness of the joints
- Pain on movement or pressure in at least one joint
- Soft tissue swelling or effusion (fluid accumulation) in at least one joint
- Swelling in at least one other joint (free interval maximum 3 months).
- Bilateral symmetrical joint swelling
- Rheumatoid nodules
- Typical changes in the X-ray image
- Rheumatoid factors in the blood positive
- Positive detection of certain mucins (mucins) in the blood, which protect the skin from chemical or mechanical effects.
- In the cell image (histological examination) visible typical changes in the synovial membrane (synovium).
