January 29th, 2011
Rheumatoid arthritis affects the body in many ways. This disorder involves much more than simply arthritis.
Is RA a disease of “old people”?
No, rheumatoid arthritis is quite common in young men and women. The mean age of development of rheumatoid arthritis is somewhere around the age of 50.
Is this a lifelong disease?
Since the exact cause of rheumatoid arthritis is unknown, a cure is not yet possible. For this reason, it is a lifelong disease. RA is, however, a very treatable illness. In fact, an increasing number of new therapies are currently being developed for the treatment of this illness. It pays, therefore, to do everything in your power early on to stop the progression of the illness.
Might the joints in my neck he affected?
RA of the thoracic spine (chest) and the lumbar spine (the lower back) is very rare and is usually associated with another illness. However, the spine in the neck area can be greatly affected. Early on, the neck can get very stiff and even lose some range of motion.
What about my shoulders?
Loss of motion of the shoulders is a common finding in RA patients. In fact, the shoulders can become frozen in place. The pain is worse at night when you are sleeping because the movements during sleep stretch the tightened joint capsule. This capsule gets really tight when there is extra fluid in the shoulder joint, which is not always obvious to the doctor.
How are the elbows affected?
Inflammation in the elbows is easily detected. Because a number of nerves pass through the elbow, a variety of confusing symptoms develops, including weakness of the pinky finger and numbness of the fourth and fifth fingers. Moreover, as the disease worsens, the elbow can become immobile and stay in a flexed or bent position until properly treated.
*11/141/5*
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January 22nd, 2011
Stage 4. At this point, inflamed synovium can grow (proliferate), spreading over the top of joint cartilage. When synovium grows in this way, it is called pannus. The pannus produces enzymes called collagenases, which can destroy collagen, the cartilage proteins. Neutrophils in the joint fluid can also release harmful enzymes. Although there are many beneficial enzymes in the body, these particular enzymes can break down, or degrade, the cartilage that protects the bone and joints.
Collagenases can also cause bone to break down in the area in which the synovitis meets bone. This results in the formation of tiny holes or erosions in the bone and cartilage. Erosions often occur first at the point at which protective cartilage ends at the margins of joints.
Stage 5. If the arthritis is left untreated, the pannus can further invade and erode through cartilage and bone by producing more enzymes. Any loss of cartilage reduces the amount of cushioning between the bones of the joint.
When cartilage is roughened by this erosion, the ability to have smooth joint motion is lost. People with RA can feel a grating sensation in the joint during movement, and their physicians can feel the grating of the joint during physical examination. This grating is called crepitus. If the breakdown of cartilage is persistent, the cartilage can be totally eroded by
In stage 5 RA uncontrolled swelling can cause ligaments and tendons to stretch, adding to the instability of the joint. Muscles become smaller (atrophy) and weaker because of disuse. Stretched ligaments and tendons and atrophied muscles interfere with the joint’s ability to function properly, often resulting in a joint that does not move as it was intended to. Inflammation and pannus can spread along the tendons in tenosynovitis, making the tendons weak and putting them at risk for rupture. When the cartilage is eroded and the supporting structures are loosened, other changes often occur which alter the shape and function of the joint. These mechanical changes are a result more of abnormal forces occurring across the joint than of ongoing inflammation in the joint itself.
Late in this stage, after the cartilage is totally eroded, the amount of inflammation and swelling often decreases. This is sometimes referred to as a burned-out joint. At this stage the stretched supporting structures can actually become even looser as the swelling pushing against them decreases. The looseness of these supporting structures can seriously affect the stability of the joint.
*9/209/5*
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