Rheumatoid arthritis – causes, symptoms, complications
Rheumatoid arthritis is a chronic inflammatory disease of autoimmune nature, whose characteristic lesion is symmetrical synovitis with repercussions on the entire joint (bone, cartilage, capsule, tendons).
Disease prevalence is 1% of the adult population and is the most commonly diagnosed between the ages of 30 and 55 years with a female to male ratio of 3: 1.
Symptoms of Rheumatoid arthritis
1. At the beginning symptoms are not typical, insidious (weeks, months):
– anorexia, unexplained fatigue, low-grade fever, influenced general feeling;
– morning stiffness with progressive duration (significant > 60 minutes);
– Arthralgia – inflammatory character (joint pain);
– Joint swelling;
– Arthritis (pain and redness, heat, swelling) is symmetrical and most commonly affects the joints of hands
– In 20% of cases – acute onset (a few days)
2. During the evolution of rheumatoid arthritis joint manifestations dominate the clinic picture – caused by bone lesions: diffuse osteoporosis, bone cysts with fluid and necrotic tissue with marginal erosion, thinning of cartilage, extra-articular lesions (rare), rheumatoid nodules (20% of cases).
– the suffering of wrists is the most pronounced symptom: joint stiffness (hours) – in the morning, arthralgia, arthritis, muscle pain, functional limitation, deformations;
– Leg joints are frequently affected during disease onset and are interested the homologous joints of the hands, causing difficulty of walking.
– Knee joints: are commonly affected and can be present: hidrarthrosis, patellar shock, Baker cyst in the popliteal space;
– Other affected joints: elbow, shoulder, hip, cervical spine: subluxated atlantoaxial joint (C1/C2);
– other symptoms: dysphagia, hoarseness, neck pain;
Involvment of other organs
– General signs: malaise, fatigue, weakness, low-grade fever, lymphadenopathy (sign of seriousness);
- heart: pericarditis (most often), coronary inflammation, conduction disturbances;
- lung: pleural effusion, Caplan syndrome, diffuse interstitial fibrosis;
- brain: peripheral neuropathy, mononeuritis , cervical myelopathy (caused by atlantoaxial subluxation);
- Eyes: Sjögren syndrome, episcleritis, scleritis with scleromalacia perforans;
- enlarged spleen: Felty syndrome, amyloidosis.