Synonyms in a broader sense
- Rheumatoid Arthritis (R. A.RA)
- Chronic polyarthritis (c. P.cP)
- Disease from the rheumatic form
- Primary chronic polyarthritis (pcPp. c. P.)
Definition
The most frequent inflammatory joint disease belonging to the rheumatic form circle is the so-called (seropositive) rheumatoid arthritis or chronic polyarthritis. It is a systemic inflammatory disease, i.e. affecting the entire body, usually progressive, which affects the organs (joints, tendon sheaths, bursae) lined by a so-called synovialis. In the course of the disease, joints and tendons are destroyed, which leads to deviations in form and axis as well as restrictions in movement.
The course of rheumatism varies greatly, in rare cases organs outside the locomotor system (eye, skin, vessels, lungs, heart, kidney or gastrointestinal tract) are also affected. About 1% of the population, without significant geographical or racial differences, suffer from rheumatoid arthritis. Women are three times more frequently affected than men.
Men usually contract the disease between the ages of 45 and 65, women between the ages of 25 and 35 or after the age of 50. Typical X-ray image of a hand suffering from advanced rheumatoid arthritis. Typical is the medically designated “ulnar deviation” of the hand. This means that the fingers deviate in the direction of the little finger. Due to modern medication, these pronounced rheumatic changes are seen less and less often.
Cause
The cause of R. A. (= rheumatoid arthritis) is largely unknown. However, an isolated familial clustering of the disease makes a genetic component probable.
Several genetic factors are assumed which control certain immune reactions and become independent under certain conditions, thus triggering the inflammation characteristic of rheumatoid arthritis primary chronic polyarthritis. Various pathogens (e.g. Epstein-Barr virus) or a pathogen substance common to several pathogens (e.g. a glycoprodefen) are suspected as triggers.
Symptoms
The misdirected immune reaction leads to inflammation of the joint mucosa lining all joints (= synovitis). This thickens and forms more synovial fluid (joint effusion). A painful joint swelling develops.
As a result, the joint capsules and the ligamentous apparatus of the joints are overstretched and the joints can become unstable. The inflamed and proliferating joint mucosa gradually spreads to the joint cartilage. Together with released enzymes (aggressive joint proteins), the joint cartilage is destroyed over time.
In advanced stages, the inflamed tissue undermines the bone from the edges of the joint and eventually leads to the destruction or deformation of the entire joint. In most cases, rheumatoid arthritis (RA) begins insidiously. Typical symptoms are: Usually, there is a morning stiffness lasting up to three hours, i.e. loss of function of the affected joints and subsequent “thawing” with a significant increase in function.
The most common joints affected are the finger, hand, elbow, shoulder, knee, ankle and toe joints, usually symmetrically. However, practically all joints, including the spine, can be affected by chronic polyarthritis (cP). Sometimes, general signs of the disease such as fever, rapid exhaustion, loss of appetite and weakness also occur.
Besides the joints, the tendon sheaths can also be affected by rheumatoid arthritis. This inflammation of the tendon sheath (= tendovaginitis) usually occurs in the hand area and can lead to a torn tendon. Furthermore, so-called rheumatic nodules occur in about 30% of patients. These are small nodules that form in the area of bony protrusions, tendons or ligaments and whose size often depends on the inflammatory activity of the disease.
- Pain in case of pressure or movement,
- Swelling and
- Overheating of joints.
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