Rheumatoid arthritis Causes, symptoms, treatment

Rheumatoid arthritis >Causes, symptoms, treatment


What is Rheumatoid arthritis:-

  • Rheumatoid arthritis is an autoimmune disorder that causes symmetrical polyarthritis.
  • Arthritis is an inflammation of the joints.
  • Rheumatoid arthritis awareness day is celebrated on 2nd Feb.
  • Rheumatoid arthritis is a most common systemic inflammatory disease characterized by symmetrical joint involvement.

Rheumatoid arthritis Definition 

  • Rheumatoid arthritis is a chronic autoimmune disorder that include inflammation in the membrane lining of the joint and produce an inflammatory synovitis.
  • Rheumatoid arthritis generally involves small, peripheral and systemic or non-weight wear joints.
  • Commonly prevalence between the age of 30 – 50 years.

Cause of Rheumatoid arthritis

  • Idiopathic
  • Genetic factors
  • Environmental exposure
  • Immunological factor
  • Autoimmune disorder
  • Endocrine imbalance
  • Inflamed synovium
  • Tumour necrosis factor
  • DM, obesity
  • Lack of exercise
  • Vitamin D deficiency
  • Smoking
  • Bacterial and fungal infection
  • Antigen dependent activation of T- lymphocytes.
  • Metabolic imbalance.

Pathophysiology of Rheumatoid arthritis

Cause / immunological / autoimmune

Inflammation of synovial membrane of joint

Antigen and antibody reaction

Damage the articular cartilage

More production of granular tissue and edema

Decrease joint mobility


Stage of Rheumatoid Arthritis

Stage – I 

– Preclinical stage

 Non sign symptoms

– Increased ESR, C – reactive protein.

Stage II

  • Synovitis stage involves inflammation in the synovial membrane.
  • Show sign symptoms.
  • ADL affects.

Stage III

  • Destruction stage
  • Daily living activity affect
  • Both bones rub together and cause pain and swelling.

Stage IV

  • Deformity stage
  • End stage of rheumatoid arthritis
  • Loss of joint functions.

Sign and Symptoms of Rheumatoid arthritis 

  • Swelling and edema in the joints.
  • Morning joint stiffness.
  • Sever pain
  • Tenderness or redness
  • Deformity of joints ( loss of anatomy )
  • Reduce range of motion
  • Muscles pain
  • Rheumatoid nodules
  • Low grade fever
  • Fatigue and weight loss
  • Swan neck deformity
  • Polyarthritis and joint warmth.

Diagnosis of Rheumatoid arthritis

  • History collection and physical examination.
  • Joint x-ray ( show deformities )
  • Blood test – increase ESR, increased C reactive protein.
  • CT scan and MRI.
  •  Anti citrullinated protein antibodies (ACPAs).
  • History of infection.

Treatment of Rheumatoid arthritis

  • NSAID (non-steroidal anti-inflammatory drugs) and Aspirin used for pain.
  • Corticosteroids drugs – prednisolone (anti-inflammatory)
  • Topical analgesics (zostrix)
  • Immunosuppressive agents – methotrexate
  • Antirheumatic drugs – D. Penicillin
  • Chloroquine.
  • Disease-modifying ant rheumatic drugs (DMARD).

Surgical Management

  1. Arthroplasty – joint replacement surgery.
  2. Arthroscopy – is a surgical procedure on a joint to examine and treatment of damaged tissue by using arthro.
  3. Synovectomy – remove inflamed joints tissues.

Nursing Management  

  • Nurses monitor vital signs and joint immobility.
  • Assess small and peripheral joints are affected.
  • Assess patient range of motion.
  • Help to reduce morning joint stiffness, provide hot tea and hot bath.
  • Nurses provide a variety of comfort levels.
  • Provide rest, heat and cold application of message to reduce pain.
  • The Administrator prescribed medication.
  • Nurses encourage patients to verbalize feelings about pain and stiffness.
  • Identify causing emotional and physical factors that cause fatigue.
  • Nurses encourage independence in mobility or activity and assist them.
  • Nurse conduct counselling for self-care activity.
  • Provide physiological and emotional support.
  • Nurses provide health education.

Key Points

  1. Inflammation in the joints – Arthritis.
  2. Autoimmune joint disorder involves synovitis – Rheumatoid arthritis.
  3. Rheumatoid arthritis is more severe in – Women.
  4. Which type of joints are involved in rheumatic arthritis – Non weight wear joints.
  5. Which stage of rheumatoid arthritis involves the deformity – Stage IV.
  6. In which disorder is the swan neck deformity seen – Rheumatoid arthritis.
  7. Surgical joint replacement – Arthroplasty.
  8. Morning joint stiffness reduced by – Hot tea and hot bath.
  9. Surgical removal of infected joint tissue – Synovectomy.
  10. Rheumatoid arthritis deformity assessed by – Radiological examination (x-ray).
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