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COURSE AND PROGNOSIS OF RHEUMATOID ARTHRITIS (RA): HOW DOES RA USUALLY START?

admin — Sun, 30 Jan 2011 08:56:13 +0000

Variability is the key ingredient in the answer to this question. Most commonly, RA starts gradually, with pain and stiffness in one or more of the joints. Usually, people first notice these symptoms in their hands. Early on, swelling may not be apparent, despite sensations of pain or stiffness. As the amount of pain slowly increases, however, swelling becomes obvious. Swelling in the joints usually appears within months of the onset of pain in the joints. Rarely, swelling does not appear until years after pain begins.
For seven out of ten people with RA, the symptoms of arthritis appear in matching joints, on both sides of the body; this is called symmetrical arthritis. For example, the left and right wrists may both be affected or the left and right knees. In addition to feeling pain in the joints, people experiencing the early symptoms of RA may feel very fatigued, as though they were recovering from a cold or the flu.
For some people, RA begins differently. These people may notice only increasing stiffness (particularly in the morning) without experiencing a great deal of pain. Others notice only progressively severe swelling, initially without pain. Still other people experience bouts of joint pain or swelling which appear suddenly and then disappear just as quickly. Someone who has these recurring attacks or flare-ups of arthritis which resolve quickly may be given a diagnosis of palindromic rheumatism before diagnostic evidence for RA develops.
Less commonly, RA can begin with only one or two tender, swollen joints in an asymmetrical pattern, that is, the joints affected on one side of the body are different from the joints affected on the other side of the body. Since this is an unusual way for RA to begin, health care providers may be hesitant about confirming a diagnosis of RA based on these symptoms. In time, about half of the people whose joint pain begins in an asymmetrical pattern will develop the more typical symmetrical pattern of RA.
RA sometimes begins as aching and stiff muscles, particularly in the shoulders and hips. This non-specific aching may continue for weeks or months before the swelling of joints appears. Older individuals are more likely than younger people to have muscle aches and stiffness appear as the first sign of RA.
Finally, RA may appear as rapid onset arthritis, with swelling and pain in many joints as well as such systemic symptoms as severe fatigue, low-grade fever, loss of appetite, and weight loss seemingly developing overnight.
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RHEUMATOID ARTHRITIS AND MUSCULOSKELETAL SYSTEM: BONES AND TENDONS

admin — Mon, 24 Jan 2011 08:54:32 +0000

What is bone?
Bone is the hard connective tissue that composes the skeleton and holds us upright. The muscles, tendons, and nerves depend on the bone.

How does RA affect bone?
Rheumatoid arthritis causes erosion of bone. The bone that surrounds the joint is most affected by this process.

What is a tendon?
Tendons are a very strong type of connective tissue that attach the muscles to bone. They allow the muscle to pull the bone as it contracts.

Can RA affect tendons?
Yes, RA can have a terrible effect on tendons, causing them to weaken, get inflamed, and even break apart.

What is osteopenia?
Osteopenia is a reduction in bone mass. This is not to be confused with osteoporosis, which is a condition marked by the progressive decrease in bone mass. Osteopenia is generally recognized as the beginning of osteoporosis.

How does the doctor test for osteoporosis?
The doctor can do a bone density (also known as a DEXA – dual energy X-ray absorptiometry) scan to see if your bones are normal for your age. You can also get a blood test to measure by-products of bone growth, which can confirm a diagnosis of osteoporosis.

Are osteoporosis and osteopenia seen in RA?
Yes. In fact, one of the earliest signs of trouble in the RA patient’s skeleton is what is called periarticular osteopenia, a condition in which the bone around the joint is often “bleached” of calcium, giving it an empty appearance. This is usually the result of severe inflammation. The chemicals of inflammation come in to the bone area and actually bleach the bone of mineral.
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DIFFERENT FORMS OF ARTHRITIS

admin — Thu, 23 Apr 2009 05:38:21 +0000

Reiter’s disease

Reiter’s disease is a form of arthritis with urethritis. The infection of the urethra may not necessarily originate in sexual activity as cases following outbreaks of dysentery have been recorded. The manifestations of Reiter’s disease can occur in several ways though not necessarily all occurring in any particular patient. In many cases dysentery occurs and also lesions of the skins with a fever condition. The eyes are j sometimes affected as is the genito-urinary tract. This disease is more common in men than in women and is still of unknown cause. Probably the majority of cases do occur as a form of venereal disease but definitely not all. It is mentioned here to give an example of a form of arthritis which might not be recognized as such by many of us.

Ankylosing spondylitis

Ankylosing spondylitis is the term used to denote an inflammatory arthritic condition of the spine. The causes of ankylosing spondylitis are not known but it is not restricted to the human animal. It would appear once again that this condition is more prominent in men than in women. A simple description of ankylosing spondylitis would be the seizing up of the lower spinal column due to a kind of fusion of the segments of the column. Although this condition does not seem to be as frequently mentioned as rheumatoid or osteoarthritis, it is in fact relatively common as a cause of back trouble in men. It is probably the most common cause of persistent back trouble in young men in their late teens and early twenties.

Carpal tunnel syndrome

Carpal Tunnel Syndrome is characterized by pain, usually in the first three fingers of the hand, together with paresis (a form of paralysis), with the symptoms being worse at night. It is created by compression and pressure on the median nerve passing through the carpal tunnel beneath a strong ligament. The carpal tunnel runs through the bones in front of the wrist through which the finger tendons and the median nerve pass. There is not much room to spare in the tunnel and if inflammation and swelling of the lining occurs, pressure bears on the nerve. The paralysis of the fingers occurs as a result of this interference with the nerve.

Fibrositis

Fibrositis is the name generally used in relation to non-articular rheumatism of the strong spinal muscles of the back known as lumbago. The name lumbago originates from the fact that the muscles involved are the lumbar muscles. This condition is very common, particularly in men, and is quite distressing in nature as it often has psychological side-effects. Sufferers often feel frustrated and possibly even inadequate in that they are unable to carry out reasonably simple and] normal functions due to pain and stiffness in the back. They do not, however, manifest any outward physical symptoms. Such psychological stress factors are undesirable in any condition but perhaps much more so in arthritic conditions as will be discussed later in the book in more detail. Fibrositis is aggravated by cold and damp and also by sudden changes in conditions such as family worries, pre-examination nerves or change of employment. It is also influenced by the usual factors such as stress circumstances and physical position.

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