Rheumatoid arthritis – a brief overview

What is rheumatoid arthritis? Rheumatoid arthritis is an inflammatory joint disease in which the joints, typically the hand and foot joints, become inflamed. This causes swelling and pain , often followed by degradation of the joint.

What exactly happens in rheumatoid arthritis? The immune system attacks the joints and connective tissue . The joints (usually those in the limbs) are painful and stiff for about 60 minutes after getting up, and after periods of inactivity. Fever, weakness, and damage to other organs may occur .

What causes rheumatoid arthritis? The exact causes of rheumatoid arthritis are not yet known. Researchers believe that it is an autoimmune disease in which the immune system attacks the synovial membrane or connective tissue in other parts of the body (e.g. blood vessels and lungs). Ultimately , the cartilage , bones and ligaments of the affected joint are damaged, leading to deformities, instability and scarring in the joint. The degree of joint damage varies. The course of the disease can be influenced by many factors, chief among them being genetic predisposition s.

What are the risk factors for rheumatoid arthritis? Smoking

Obesity

Microbiome changes

Periodontitis

Certain foods are said to trigger attacks, but this has not yet been scientifically proven

Viral infections

What are the symptoms of rheumatoid arthritis? Rheumatoid arthritis typically begins to affect the joints gradually, but it can also occur very suddenly. The inflamed joints are usually painful and very often stiff (especially after getting up, or after a prolonged period of rest). This stiffness usually improves after about 60 minutes. The affected joints are often sensitive to touch. They become warm and enlarged because the soft tissue is swollen (synovitis) and the joint is filled with fluid (synovial fluid). Joint deformities can develop quickly. They may stiffen in a position where they can no longer be flexed or extended , so that mobility is restricted. The fingers bend towards the little finger, which can cause the finger ligaments to slip or become deformed.

Some patients feel tired and weak, especially during the course of the day. The condition may be accompanied by loss of appetite, weight loss, and low fever.

Where does rheumatoid arthritis manifest itself? Normally, the inflammation of the joints is symmetrical (affecting both sides of the body more or less equally). Although the disease can occur in all joints, inflammation often first occurs in the small joints, such as the hands, wrist s, fingers, feet and toes. It is also common in the knees, shoulders, elbows, ankles, hips and even the neck. Surprisingly, the lower spine and the joints at the ends of the fingers are not affected. In rare cases, rheumatoid arthritis can lead to vasculitis. This reduces the blood supply to the tissue and can cause nerve damage and leg ulceration. If inflammation of the pleura, lungs, or pericardium occurs with scarring, this can lead to chest pain and shortness of breath. Some people may also experience lymphadenopathy, Felty‘s syndrome, Sjögren‘s syndrome, thinning of the sclera in the eye, and redness and irritation of the eyes due to inflammation. People with rheumatoid arthritis have an increased risk of early coronary heart disease and bone disorders such as osteopenia and osteoporosis.

How is rheumatoid arthritis diagnosed? Blood tests such as rheumatoid factor (present in approx. 70 % of patients), CCP antibodies, CRP and ESR

Imaging techniques such as X-rays of the hands, wrists, etc., ultrasound or magnetic resonance imaging

Examination of synovial fluid

What are the signs of rheumatoid arthritis? Positive blood tests

Inflammation of the joints typically affected by rheumatoid arthritis

Symptoms lasting longer than 6 weeks

How is rheumatoid arthritis treated? Once an acute attack has subside d, systematic exercise is necessary to prevent the joints from stiffening and the muscles from becoming too weak. Other measures include:

Exercises and splint s, medication and sometimes surgery.

Lifestyle measures, e.g. rest, nutrition, exercise, restful sleep, and quitting smoking.

Physiotherapy and occupational therapy

Sometimes – surgical intervention

Are there specific medications for treatment? Medications are primarily intended to relieve inflammation and thus prevent degeneration, progression of the disease and the loss of joint function.

The following main groups of active ingredients are used in the medicinal treatment of rheumatoid arthritis. They may be prescribed alone, or in combination:

Disease-modifying antirheumatic drugs (DMARDs), which contain biologics.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Immunosuppressants

Corticosteroids

EXERCISE:

1. Although the disease can occur in all joints, inflammation often first occurs in the small joints, such as the hands, wrists, fingers, feet and toes. It is also common in the knees, shoulders, elbows, ankles, hips and even the neck. A) True B) False

2. What are the signs for rheumatoid arthritis? A) Positive blood tests B) Inflammation of the joints C) Symptoms lasting longer than 6 weeks D) Swollen lymph nodes E) Joint aches

3. Rheumatoid arthritis normally manifests itself in all joints of the body. A) True B) False

You’ll find the answer below.

BIBLIOGRAPHY 1. www.amboss.com 2. www.dict.cc 3. www.mayoclinic.org 4. www.nhs.uk 5. www.rheuma-liga.de 6. www.webster-dictionary.org

CARMEN LOBITZ Carmen Lobitz ist freie Trainerin, Lehrerin und MTL. 1998 gründete sie lobitz seminare in Berlin, die Englischseminare für Health Professionals anbieten. Kontakt: mail@lobitz-seminare.de www.lobitz-seminare.de

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Lösung für Exercise:

1. A

2. A bis C

3. B

Rheumatoid arthritis – a brief overview

What is rheumatoid arthritis?

What exactly happens in rheumatoid arthritis?

What causes rheumatoid arthritis?

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Rheumatoid arthritis – a brief overview

What is rheumatoid arthritis?

What exactly happens in rheumatoid arthritis?

What causes rheumatoid arthritis?

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