Description
Rheumatoid arthritis is a form of inflammatory arthritis. It is a systemic disease as other joints and systems are also affected. It leads to swelling of the shoulder joint associated with very severe pain. It is an autoimmune disorder. The lining of the shoulder joint is the starting point for the deposition of the antigen antibody complexes. An inflammatory reaction arises leading to the proliferation a very vascular tissue called pannus. This pannus leads to joint destruction. In severe disease the movements of the joint are thus lost. In a patient suffering from this disease other joints like the knees, hips, elbows, hands are simultaneously affected. Typical deformities are seen in the hand.
Symptoms
· Pain in the affected joints. This is worsened by cold weather. · Swelling in the joints at least for six weeks or more. · Symmetrical affection of other joints. · Morning stiffness. · Nodules are found around the elbows. · Weakness as there is an associated anaemia. · The joints of the fingers, wrist and hand are invariably affected.
Causes and risk factors
Certain genetically predisposed individuals can be affected. Female gender. Family history of arthritis.
Investigations
In the early case the diagnosis has to be made by blood tests. The Rheumatoid factor (RA factor) is positive in 70% of patients. Anaemia is invariable. The erythrocyte sedimentation rate is high (ESR)
Treatment
In early cases the disease can be kept under check by anti-inflammatory drugs. Later disease modifying drugs are used. Intra articular steroid injections can control the inflammation in joints. When joint swelling is resistant to the above, medical or surgical synovectomy is done. If joint destruction progresses then a joint replacement is required (Shoulder replacement) |
