Rheumatoid arthritis

"The goals of treatment are to decrease patients' symptoms and disability and to prevent permanent damage to the joints".

DR. Mª JOSÉ CUADRADO LOZANO
DIRECTOR. RHEUMATOLOGY SERVICE

Rheumatoid arthritis is a disease in which the joints become inflamed, producing pain, deformity and difficulty in movement, although it can also affect other parts of the body.

It is a chronic disease, with a low frequency of spontaneous cure, although with a suitable treatment a good control of the disease is obtained in most of the cases.

It is more frequent in women, but it also affects men. It occurs most frequently between the ages of 45 and 55. Also, a very similar form of arthritis can affect children.

Whereas in the arthritis a slow process of wearing away of the articular cartilage exists (the weave that covers the bone and acts of shock absorber), in the arthritis a chronic inflammation of the synovial membrane takes place (the "bag" that covers the articulation) that gives rise to pain and difficulty for the movement and ends up damaging very quickly the cartilage, the bone, the ligaments and the tendons.

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What are the symptoms of rheumatoid arthritis?

The most frequently swollen joints are the wrists, fingers, toes, elbows, shoulders, hips, knees and ankles.

In the mornings, there may be difficulty in initiating movement (morning stiffness) of varying duration.

Persistent inflammation can end up damaging the surrounding bones, ligaments and tendons. The consequence will be a progressive deformity of the joints and reduced joint mobility, which can lead the patient to a certain degree of disability to do some tasks of daily life.

Other less frequent symptoms are: unexplained fever, easy tiredness, neck pain, tingling in the hands or feet, pain in the chest or sides, dry mouth, redness or gritty feeling in the eyes and spots or lumps in the skin.

<p>Imagen preview del infográfico sobre la artritis reumatoide</p>

Learn what rheumatoid arthritis is and how it is treated (available in spanish)


The most common symptoms are:

  • Inflammation of joints.
  • Morning stiffness.
  • Progressive deformity of joints.
  • Reduction of the articular mobility.

Do you have any of these symptoms?

You may have rheumatoid arthritis

What are the causes of rheumatoid arthritis?

The cause of rheumatoid arthritis is unknown. Infectious agents have been studied (bacteria, virus...) and although suggestive data have been found in some cases, there is no evidence to confirm the involvement of any one in particular.

Rheumatoid arthritis is classified as an autoimmune disease, which develops because certain cells of the immune system do not function properly and begin to attack healthy joints.

How is rheumatoid arthritis diagnosed?

The rheumatologist assesses the symptoms presented by the patient and performs a physical examination to check for heat, pain and swelling in the joints.

The findings that can be found in the x-rays and some analytical studies (VSG, PCR, rheumatoid factor, anticyclic citrulline peptide antibodies or Ac anti-CCP) are very useful to confirm the diagnosis.

A good control of rheumatoid arthritis requires an early diagnosis.

How is rheumatoid arthritis treated?

The treatment and monitoring of this disease is carried out in a joint and multidisciplinary way with other services.

  • Non-steroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids: to relieve pain and inflammation.
  • Disease modifying drugs (DMARDs): these are immunosuppressive drugs (methotrexate, sulfasalazine, leflunomide...).
    Used to control the activity of rheumatological diseases. Its proper use aims to induce or maintain remission of the disease, reduce the frequency of relapses and reduce the administration of steroids.
    Those patients with an established diagnosis of rheumatoid arthritis should begin treatment with disease-modifying anti-rheumatic drugs. These drugs are often used in conjunction with nonsteroidal anti-inflammatory drugs and/or low-dose corticosteroids.
  • Biological drugs: used in patients who do not respond to DMARDs or in patients with very active disease from the onset of symptoms. They are safe drugs, but prior to the start of such treatment it is necessary to perform screening for latent tuberculosis infection and rule out infection by hepatitis B and C virus.

If a swollen joint persists, it can be acted upon locally by infiltration in order to reduce the inflammation.

It is also possible to act locally on especially inflamed joints with special orthopedic material. It is possible that, during the evolution of the disease, some articulation is specially damaged and it is necessary to make some type of repairing surgery.

  • It is advisable to sleep an average of 8-10 hours at night.
  • You should avoid activities that require physical effort, require long periods of standing or require repetitive movements, especially with your hands.
  • In domestic work, try not to use your hands. There are utensils that can be of great help for domestic tasks.
  • In the periods of little inflammation, it is very recommendable to practice some physical exercise in a habitual way and without getting tired.
  • During your rest, you should adopt a proper posture, and avoid bending your joints.
  • The use of adequate footwear is fundamental.
  • An inflamed joint must be kept at rest. However, it is very convenient to have a good musculature around the inflamed joint, but without moving said joint ("isometric" exercises)
  • The use of devices that maintain the proper position of the fingers (splints) for night use, prevents future deformities.

Where do we treat it?

IN NAVARRE AND MADRID

OUR MEDICAL TEAM
Rheumatology Service Specialists

The Rheumatology Service has a multidisciplinary team highly specialized in the diagnosis and treatment of rheumatological diseases, from osteoarthritis, arthritis or osteoporosis to autoimmune or inflammatory diseases.

In addition, we have doctors specialized in assisting pregnant women with autoimmune diseases, in order to guarantee the maximum safety of the fetus.

Organized in specialized units

  • Inflammatory arthropathies.
  • Degenerative arthropathies.
  • Microcrystalline arthropathies.
  • Bone pathology.
  • Systemic autoimmune diseases.
  • Autoinflammatory diseases.
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