The medical approach of the specialists who are part of the Panama Clinic Orthopedic Center (COPAC), is focused on controlling symptoms and delaying the evolution of the disease to improve the patient’s quality of life and prevent permanent damage from occurring that places them at risk of disability.
Rheumatoid arthritis is an autoimmune disease of chronic inflammation that occurs when a person’s own immune system mistakenly begins to attack other healthy tissues in the body. In general, the worst damage is received by the joints (wrists, ankles, hips, knees, elbows, shoulders, fingers and toes), on both sides of the body equally. However, as it progresses, it can spread to the lungs, heart, eyes, mouth, among others.
In rheumatoid arthritis, inflammation of the synovial membrane (tissue that lines the joint cavity) occurs, this persistent accumulation of fluid causes bones, cartilage, ligaments and joint tendons to suffer great deterioration in a short time.
Due to the same inflammation and bone erosion of rheumatoid arthritis, progressive deformation of the joints also occurs; Over time, the patient may suffer from a certain degree of disability to perform many of their usual tasks.
The symptoms of the disease can be of variable intensity, sometimes the patient may experience intense flare-ups that with proper treatment could disappear completely.
Initial symptoms of rheumatoid arthritis include joint pain and tenderness, especially in the mornings or after periods of inactivity. It is also common to experience stiffness that can last for several hours, as well as swelling and redness in the affected joints.
Rheumatoid arthritis triggers visible changes in joint anatomy, including: inflammation, swelling, and deformity, which tends to hinder normal movement of the affected joints. Over time, rheumatoid arthritis can cause irreversible joint damage if not treated properly.
In more severe cases, the patient may experience signs such as: pleurisy (inflammation of the lung tissues and chest cavity), dry mouth and eyes, appearance of nodules under the skin, numbness of hands and feet, insomnia…
The diagnosis of rheumatoid arthritis consists of the following:
The specialist performs the thorough review of the patient’s symptoms, followed by a detailed examination of the joints and other affected areas. This helps determine the extent of the disease and establish an appropriate treatment plan.
Blood tests essential for the diagnosis of rheumatoid arthritis include the measurement of factors such as rheumatoid factor, anti-cyclic citrullinated peptide (anti-CCP) antibodies, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).
Rheumatoid factor is an antibody that is overproduced by the immune system in people with rheumatoid arthritis. On the other hand, cyclic citrullinated peptide (anti-CCP) is an antibody that attacks citrullinated proteins; Its presence in the blood is also associated with rheumatoid arthritis.
Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are laboratory tests used to measure inflammation in the body. In the case of rheumatoid arthritis, elevated levels of ESR and CRP in the blood confirm the existence of active inflammation in the joints.
Imaging techniques commonly used in the detection of rheumatoid arthritis include:
They are used to detect changes in the joints, such as bone erosions, narrowing of the joint space, and deformities. These images help doctors assess the degree of joint damage caused by rheumatoid arthritis.
Ultrasound and MRI allow for detailed visualization of joints and surrounding soft tissues. These tests can help identify synovial inflammation, bone edema, and erosions, which contributes to the diagnosis and follow-up of rheumatoid arthritis.
Antinuclear antibody (ANA) tests are used to identify the presence of autoantibodies that attack the nuclei of cells. If ANAs are present in the blood, there is a greater chance that the patient is experiencing an autoimmune disease such as rheumatoid arthritis.
Liver and kidney function evaluation involves laboratory tests to evaluate the health and function of the liver and kidneys. These tests are important in patients with rheumatoid arthritis, as some medications used in the treatment of the disease affect the function of these organs.
So far, the real cause of this disease is unknown. Although many claim that its origin is related to a genetic component, it is not yet scientifically proven what causes the immune system to attack its own healthy joint tissues.
Rheumatoid arthritis is a disease that has no cure. However, early diagnosis and treatment can increase the chances of a remission of symptoms.
Patients may go through one or more types of treatment throughout their lifetime with the disease. Methods frequently used in the treatment of rheumatoid arthritis include:
Among the first options are disease-modifying antirheumatic drugs in combination with anti-inflammatory drugs, to achieve pain relief and decrease inflammation.
Physical therapy exercises can help you increase range of motion, maintain muscle strength, and slow the decline of joint function. The physiotherapist, in addition to applying hot/cold therapies to inflamed joints, will also teach you how to re-educate the way you perform some daily activities to make tasks easier and prevent your joints from overexerting themselves.
If physical therapy and medications have not interrupted the progress of the disease, the specialist may recommend some of these surgical procedures to repair joint damage, including:
Synovectomy: During this procedure, inflamed synovial tissue is removed from the joint, which helps increase flexibility and improve the sensation of pain.
Tendon repair: Rheumatoid arthritis often causes the tendons of the affected joint to rupture or stretch, which must be repaired by surgery.
Joint fusion: Fusion surgery allows for the surgical realignment of deformed structures and increased stability.
Joint replacement: Through this operation, the surgeon removes the damaged joint parts and replaces them with metal prostheses.
People with rheumatoid arthritis should avoid:
Do high-impact sports and exercises (running, jumping, etc.).
Ignoring the suggested treatment.
Exceeding recommended treatment doses.
Smoke.
Focus your thoughts on the negative.
The most important thing is to comply with the treatment and follow the medical advice thoroughly; In addition to this, you can:
Stretch your joints daily so you don't lose mobility.
Adopt correct postures when sitting, standing up and walking.
Identify their personal limits, avoiding excessive activity.
Maintain an adequate body weight.
Quit smoking.
Rely on the physiotherapist to learn what exercises and techniques can help you improve your quality of life.
Like other immune diseases, there is no key to preventing the onset of rheumatoid arthritis. However, making daily lifestyle changes such as: Increasing vitamin D intake, maintaining a healthy weight, eating a balanced diet, exercising daily, not smoking, and seeing a doctor in a timely manner can significantly reduce your risk of rheumatoid arthritis.
