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rheumatoid arthritis
LemonDKel
2022. 7. 30. 03:53
Overview
Rheumatoid arthritis is a disease in which joint inflammation occurs due to immune abnormalities, swelling and severe pain, cartilage and bones are destroyed, joints are deformed, and joint function is lost.When the synovial membrane surrounding the inside of the joint becomes inflamed and becomes chronic, the synovial membrane proliferates and destroys surrounding tissue.The number of patients is estimated to be 700,000 to 800,000 nationwide, and it is common among women, and the peak age of the disease is in their 30s to 50s.At first, the joints of the hands and toes swell symmetrically and become stiff in the morning.Symptoms of fever, sluggishness, and reduced appetite may also appear.In the past, it was thought to be a slowly progressing disease and limited drugs, but in recent years, biological preparations have been developed and sufficient treatment has been shown to improve joint function and QOL.cause
Rheumatoid arthritis is thought to be caused by an abnormality in immunity.Immunity is usually a system that attacks bacteria, viruses and other pathogens that enter the body from the outside and drives them out of the body, but rheumatoid arthritis causes inflammation in the joints by causing abnormalities in the immune system. The synovial membrane, which originally produces joint fluid and supports the function of the joint, is inflamed, and prolonged inflammation can lead to joint destruction. As a result, the adjacent bones of the joints are healed and hardened, or the joint structure is dislocated and the function is impaired due to looseness of the joint structure.It often occurs in small joints such as hands and toes, but when the progress is prolonged, inflammation spreads to large joints such as knees, shoulders, and hip joints.The cause of the abnormality of immunity is not known at present, but genetic factors, smoking habits and periodontal diseases have been pointed out.symptom
In the beginning, the joints of the fingers and toes were swollen symmetrically, and they began to feel stiff in the morning.If joint destruction occurs over time, even small joints can cause serious problems in life.In some patients, large joints in the lower extremities, such as knee joints and hip joints, may also be affected, making walking extremely difficult.Furthermore, when inflammation spreads to the cervical vertebrae, symptoms (palsy limbs and weakness) due to compression of the spinal cord may occur, and emergency surgery may be required.In addition to these joint symptoms, various systemic symptoms (fever, fatigue, appetite, anemia, etc.) can be accompanied.In particular, interstitial pneumonia is a serious complication that reduces respiratory function and has a significant effect on QOL and life prognosis, and can be aggravated by infectious diseases and drugs.It can also be combined with vasculitis, which causes various symptoms such as skin ulcers, peripheral nerve damage, and eye inflammation.examination and diagnosis
Rheumatoid arthritis is often diagnosed based on the classification criteria of the American Society of Rheumatology, combining medical examinations, imaging and blood tests as well as medical examinations and physical examinations.X-ray examinations are still important to understand the overall picture of joints, but ultrasound can observe inflammation of the synovial membrane in real time. The inflamed synovial membrane thickens and abnormal blood flow is seen inside.As the joint fluid increases, the expanded joint cavity can be observed, and the appearance (bone erosion) of the osteoderma can be diagnosed relatively early. MRI examination is also useful for early diagnosis of bone erosion, but the disadvantage is that the examination takes time and money.In the blood test, inflammatory reactions, rheumatoid factors, and anti-CCP antibodies are useful for diagnosis, and other diseases that cause arthritis are distinguished by thyroid tests, anti-nuclear antibodies, and virus tests.treatment
The treatment of rheumatoid arthritis is based on four pillars: drug therapy, surgical therapy, rehabilitation and self-care.Drug therapy includes non-steroidal anti-inflammatory drugs (NSAID), adrenal cortical steroids, disease-modifying anti-rheumatic drugs (DMARD), and biological preparations. Among them, NSAID and steroids relieve symptoms such as pain and swelling relatively quickly, but they have little effect in suppressing joint destruction. DMARD, including methotrexate, and biological preparations developed based on the latest immunological knowledge, suppress abnormal immunity and joint destruction, but due to individual differences in effectiveness, side effects and cost problems, the choice of treatment requires a specialist.Although the number of cases is decreasing due to advances in treatment, if the joint inflammation is not controlled for a long time and the joint is deformed and the function is discontinued, surgery may be necessary to replace it with an artificial.precautions after prevention/treatment
Once an inflamed joint may be structurally vulnerable and may cause secondary damage due to excessive load.It is very important to carry out appropriate rehabilitation to maintain and improve joint function.In some cases, drugs with immunosuppressive effects are administered, and it is also important to prevent infectious diseases by washing hands, gargling, taking enough rest, and vaccinating.The risk of osteoporosis increases during steroid administration, so it is necessary to be careful not to fall down, especially in the elderly.
Rheumatoid arthritis is a disease in which joint inflammation occurs due to immune abnormalities, swelling and severe pain, cartilage and bones are destroyed, joints are deformed, and joint function is lost.When the synovial membrane surrounding the inside of the joint becomes inflamed and becomes chronic, the synovial membrane proliferates and destroys surrounding tissue.The number of patients is estimated to be 700,000 to 800,000 nationwide, and it is common among women, and the peak age of the disease is in their 30s to 50s.At first, the joints of the hands and toes swell symmetrically and become stiff in the morning.Symptoms of fever, sluggishness, and reduced appetite may also appear.In the past, it was thought to be a slowly progressing disease and limited drugs, but in recent years, biological preparations have been developed and sufficient treatment has been shown to improve joint function and QOL.cause
Rheumatoid arthritis is thought to be caused by an abnormality in immunity.Immunity is usually a system that attacks bacteria, viruses and other pathogens that enter the body from the outside and drives them out of the body, but rheumatoid arthritis causes inflammation in the joints by causing abnormalities in the immune system. The synovial membrane, which originally produces joint fluid and supports the function of the joint, is inflamed, and prolonged inflammation can lead to joint destruction. As a result, the adjacent bones of the joints are healed and hardened, or the joint structure is dislocated and the function is impaired due to looseness of the joint structure.It often occurs in small joints such as hands and toes, but when the progress is prolonged, inflammation spreads to large joints such as knees, shoulders, and hip joints.The cause of the abnormality of immunity is not known at present, but genetic factors, smoking habits and periodontal diseases have been pointed out.symptom
In the beginning, the joints of the fingers and toes were swollen symmetrically, and they began to feel stiff in the morning.If joint destruction occurs over time, even small joints can cause serious problems in life.In some patients, large joints in the lower extremities, such as knee joints and hip joints, may also be affected, making walking extremely difficult.Furthermore, when inflammation spreads to the cervical vertebrae, symptoms (palsy limbs and weakness) due to compression of the spinal cord may occur, and emergency surgery may be required.In addition to these joint symptoms, various systemic symptoms (fever, fatigue, appetite, anemia, etc.) can be accompanied.In particular, interstitial pneumonia is a serious complication that reduces respiratory function and has a significant effect on QOL and life prognosis, and can be aggravated by infectious diseases and drugs.It can also be combined with vasculitis, which causes various symptoms such as skin ulcers, peripheral nerve damage, and eye inflammation.examination and diagnosis
Rheumatoid arthritis is often diagnosed based on the classification criteria of the American Society of Rheumatology, combining medical examinations, imaging and blood tests as well as medical examinations and physical examinations.X-ray examinations are still important to understand the overall picture of joints, but ultrasound can observe inflammation of the synovial membrane in real time. The inflamed synovial membrane thickens and abnormal blood flow is seen inside.As the joint fluid increases, the expanded joint cavity can be observed, and the appearance (bone erosion) of the osteoderma can be diagnosed relatively early. MRI examination is also useful for early diagnosis of bone erosion, but the disadvantage is that the examination takes time and money.In the blood test, inflammatory reactions, rheumatoid factors, and anti-CCP antibodies are useful for diagnosis, and other diseases that cause arthritis are distinguished by thyroid tests, anti-nuclear antibodies, and virus tests.treatment
The treatment of rheumatoid arthritis is based on four pillars: drug therapy, surgical therapy, rehabilitation and self-care.Drug therapy includes non-steroidal anti-inflammatory drugs (NSAID), adrenal cortical steroids, disease-modifying anti-rheumatic drugs (DMARD), and biological preparations. Among them, NSAID and steroids relieve symptoms such as pain and swelling relatively quickly, but they have little effect in suppressing joint destruction. DMARD, including methotrexate, and biological preparations developed based on the latest immunological knowledge, suppress abnormal immunity and joint destruction, but due to individual differences in effectiveness, side effects and cost problems, the choice of treatment requires a specialist.Although the number of cases is decreasing due to advances in treatment, if the joint inflammation is not controlled for a long time and the joint is deformed and the function is discontinued, surgery may be necessary to replace it with an artificial.precautions after prevention/treatment
Once an inflamed joint may be structurally vulnerable and may cause secondary damage due to excessive load.It is very important to carry out appropriate rehabilitation to maintain and improve joint function.In some cases, drugs with immunosuppressive effects are administered, and it is also important to prevent infectious diseases by washing hands, gargling, taking enough rest, and vaccinating.The risk of osteoporosis increases during steroid administration, so it is necessary to be careful not to fall down, especially in the elderly.