Review of the symptoms of rheumatoid arthritis: signs of damage to joints and entire organs

Rheumatoid arthritis is a chronic systemic disease that primarily affects joint surfaces with the development of symptoms of joint inflammation (arthritis) – redness, swelling, pain, and impaired function. But since the systemic process, in addition to changes in the joints, the symptoms of rheumatoid arthritis also include signs of damage to other organs and systems: the heart, blood vessels, kidneys, lungs, skin, etc.

Rheumatoid Arthritis A very serious illness whose symptoms must not be ignored: joint lesions evolve very rapidly, leading to irreversible loss of function. Without adequate treatment, about half of patients with rheumatoid arthritis become disabled 5 years after the onset of the disease. Life expectancy also decreases (for example, because the immuno-inflammatory process extends to the heart and other organs, infections are attached to it, etc.)

Fast and complete treatment, well that not likely to lead to complete cure, can significantly slow the progression of the disease, prevent early disability and alleviate painful symptoms.

The main manifestations of rheumatoid arthritis:

1. Symptoms of arthritis proper (articular syndrome).
2. Signs of pathological changes in other organs (systemic manifestations)

Articular syndrome

For symmetrical rheumatoid arthritis (that is, simultaneously on both sides) changes in the small joints of the hand: metacarpophalangeal, interphalangeal, and also small joints of the feet (metatarsophalangeal). Over time, changes and painful symptoms appear in other joints: wrist, tarsus, elbow, ankle, knee, shoulder, temporomandibular hip, hip, cervix uterus.

In rare cases, the disease begs ins inflammation of a large joint (knee, elbow, etc.).

Symptoms of joint damage:

• pain;
• morning stiffness;
• edema;
• redness around the joint; [19659006] violation of function
• atrophy;
• articular deviations, deformities and ankylosis.

Symptoms of involvement of articular surfaces increase gradually. In the initial stage, the signs of inflammation may be unstable, even a short-term spontaneous remission is possible (when alone – without treatment – the articular syndrome passes), but after a few weeks or months, the pain returns and begins to increase, and the disruption of the function increases.

Pain, joint malformations, deviations and ankylosis result in significant impairment of the functions of the hands and limbs, reducing the patient's quality of life and ability to self-serve. Patients can not perform the most usual actions: buttons and zippers on the clothes, lift and hold the teapot, glass and spoon, open the door with a wrench.

Defeat of the joints of the lower limbs (hip, knee), ankle) leads to a restriction of movement – at first there are pains with physical activity and walking, then the ability to standing and leaning on the legs becomes difficult, it becomes difficult for patients to walk without additional support on the cane and crutches.

Pain in joints

Pain in joints worries at an initial stage of a disease only when moving: with typical localization with injury of small joints of a hand, attempts to bend fingers and joints movements associated with the pen during writing, buttoning and other work with the fingers) become painful.

As the disease progresses, the pain becomes chronic, worries patients already and at rest, including at night

Morning stiffness

This is the limitation, the impossibility of make complete movements in the morning after waking up. Morning stiffness is an important diagnostic sign of rheumatoid arthritis if it persists for one hour or more

Swelling and redness

Symptoms such as swelling and redness around the joint occur simultaneously or after pain syndrome . First, there is only a small transient swelling and a slight redness, in the future swelling becomes permanent, dense, and the skin on the joints – red, thin, shiny.

Violation of function

Violation of function in the form of limited or impossible work of the joints develops first as a protective reaction due to the syndrome of pain (the patient consciously or unconsciously restrains the painful movements and, in this way, spares the joint). In the later stages of rheumatoid arthritis, limitation of movement is due to the formation of joint deviations and deformities.

The inability to bend or fully deploy a limb (finger) in the joint is called contracture.

Muscular Atrophy [19659023] Muscle atrophy – thinning and weakening of muscles – results from complete or partial immobility of the limb (fingers) and transition from inflammatory process to tendons and adjacent muscles .

Deviation

Deviation – the deviation of the joints in the articular bones – develops as a result of long and irreversible muscle contractures, the formation of subluxations. A characteristic ulnar deviation – the so-called "walrus fin" – is the deviation of the fingers from the outside, towards the ulna.

Deformity

Deformation is a pronounced and disfiguring change in the shape of the joint, first because of swelling, then because of subluxations, the spread of the pathological process to articular cartilage and articular segments. In later stages, articular deformities typical of rheumatoid arthritis occur:

• the "gooseneck" of the fingers – the reopening of the first interphalangeal joint (proximal, proximal to the wrist) and flexion contracture in the second ( distal) "arachnid" brush – impossibility of putting a palm and touching it with an even surface (table, for example) due to flexion contracture of fingers and restriction of extension in interphalangeal joints [19659006] valgus deformation big toe – deviation of its outside in the metatarsophalangeal joint

Ankylosis

Ankylosis is complete immobility in the joint due to the destruction of the cartilage and the formation of fibrous and bone fusion between the bone surfaces of the bones. 19659043] Systemic manifestations

The symptoms of rheumatoid arthritis are not limited to joint damage alone. Even after the onset of the disease, there are common symptoms:

• weight loss until exhaustion (asthenic syndrome),
• fever, more pronounced in the after-the-fact midday and evening,
• increased fatigue,
• general malaise,

Over time, other organs and tissues are involved in the immuno-inflammatory process:

1. Muscles: pain in the muscles (myalgia) and inflammation (myositis)
2. Skin: it becomes thin and dry, subcutaneous hemorrhage, foci of necrosis in the form of black spots under the fingernails.

   The skin of the palms and feet becomes bluish, it becomes cold to the touch. Characteristic is the appearance of rheumatoid nodules – rounded formations, painless and dense to the touch, located under the skin on the surface of the extensor near the joints of the fingers, elbows, forearms.

3. The vessels are affected in the form of rheumatoid vasculitis (inflammation of the vessel wall) with onset of multiple subcutaneous hemorrhages, a hemorrhagic rash (rash of dark red color, cherry color ). Possible nasal bleeding, uterine. When the vessels of the internal organs are affected, heart attacks (heart, lung, intestine), hepatitis, etc. Are growing.
4. Lymph nodes increase in size in 40-60% of patients. They are painless, mobile, dense-elastic consistency.
5. Increase of the spleen.
6. Defeat of the lungs in the form of pleurisy, pneumonitis and alveolitis. Clinically, they manifest themselves by a productive cough (with coughing of expectoration), shortness of breath during physical exertion.
7. Heart failure often develops
8. The kidneys and liver are affected by the spread of the immuno-inflammatory process. , and because of the side effect of drugs used in the treatment of rheumatoid arthritis.
9. Changes in the digestive system, which are explained less by arthritis than by the adverse effects used to treat NSAIDs (nonsteroidal anti-inflammatory drugs). drug addicts). Often, patients notice a decrease in appetite, periodic nausea until vomiting, pain in the stomach area or diffuse pain in the abdomen. Relatively rare, in case of non-compliance with therapeutic recommendations and doses of drugs, NSAIDs can have more serious effects: erosion of the mucous membranes of the stomach and duodenum, acute ulcers and gastrointestinal bleeding.
10. system – in the form of polyneuropathies, manifested paresthesias (burning, tingling, numbness in the extremities), decreased pain and tactile sensitivity.

Anemia is a common companion to rheumatoid arthritis. It is characterized by a decrease in the number of red blood cells (number of red blood cells, hemoglobin, color index, etc.) and the sideropenic syndrome (external signs of iron deficiency) in the form of striation, stratification and fragility of the nails, hair

Conclusion

The symptoms of rheumatoid arthritis are very diverse. In the initial stages of the disease can occur rather slowly, without causing any particular suffering to patients. However, it must be remembered that joint damage progresses very rapidly, and over time, the pathological process can spread to other organs. Therefore, it is extremely important to immediately contact the doctor-therapist, rheumatologist or arthrologist for the examination and appointment of an appropriate treatment when the first symptoms appear.