X-ray

The diseased joints should be x-rayed annually for diagnosis and especially in the first years for monitoring the progress. The radiological changes on the x-ray image are joint space narrowing, decalcification near the joint (osteoporosis), erosion of the joint surfaces, later destruction of the joint surfaces, and stiffening bones, joint degeneration or joint dislocation.There is a radiological stage classification on the X-ray according to the severity of the joint changes in 5 stages (classification according to Larsen). Other diagnostic examinations that can be performed for specific problems are Sonography (ultrasound) of the joints or tendons, e.g. to visualize a joint effusion at the hip joint, to visualize a Baker’s cyst (popliteal cyst) in the hollow of the knee, or to visualize torn tendons in the shoulder (rotator cuff tear) or Achilles tendon (Achilles tendon tear).

Synovial analysis and histological findings: Laboratory examination of the synovial fluid or the synovial membrane. However, this is only useful for assessing the activity of the inflammation, not for making a diagnosis. Synovial analysis and histological findings: Laboratory examination of the synovial fluid or the synovial membrane. However, this is only useful for assessing the activity of the inflammation, not for diagnosis.

Stages of rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory disease caused by an excessive reaction of the body to the body’s own cells. It can be said that the immune system does not recognize the body’s own cells and for this reason fights them. The disease, which mainly affects the joints of the body, progresses in four different stages.

Stage: In most cases there is a symmetrical infestation of the metacarpophalangeal joints of both hands, as well as joint swelling. In addition, patients affected by rheumatoid arthritis in stage 1 complain of morning stiffness, which is still present longer than 30 minutes after getting up.
Stage: There is an increasing proliferation of connective tissue in the area of the affected joints and an increasing influx of inflammatory fluid into the joints. This results in an increasing restriction in the mobility of the joints during movement.
The joint capsule may also bulge out, which can also severely restrict the movement possibilities.
Stage: Malpositions of the finger joints already occur. The fingers are usually pulled in the direction of the ulna of the forearm. Due to the chronic inflammatory processes, the tendon sheaths are also gradually destroyed, with the result that the muscles that move the fingers can no longer be moved without resistance.
This leads to so-called swan neck deformations of the fingers (see subheading Rheumatism Hand/Hands).
Stage: The final stage of rheumatoid arthritis occurs in an advanced disease state. It shows severe deformities and destruction of the phalanges. Furthermore, other organs can also be affected by the rheumatic disease in this disease state. In some cases, the heart or lungs as well as the connective tissue can be affected. Due to the very good treatment options available today, very few rheumatism patients go through this stage today, since the chronic disease can be treated with medication in earlier stages.