Rheumatoid Arthritis Jennifer Pratt ENG 101 Prof. Kerr Dec. 4, 2003
<ul><li>I. Overview of the Disease </li></ul><ul><li>A. What is it? </li></ul><ul><li>B. What causes it? </li></ul><ul><li>C. What are the symptoms? </li></ul><ul><li>D. How is it diagnosed? </li></ul><ul><li>E. Who is at risk? </li></ul><ul><li>II. Effects on a Joint </li></ul><ul><li>A. Anatomy of a joint </li></ul><ul><li>B. Effects of the disease </li></ul><ul><li>C. Systemic effects </li></ul><ul><li>III. Education </li></ul><ul><li>A. Planning </li></ul><ul><li>B. Emotions and stress </li></ul><ul><li>C. Quackery </li></ul><ul><li>IV. Treatment </li></ul><ul><li>A. How to prevent disability and preserve joint function </li></ul><ul><li>B. CAM methods </li></ul><ul><li>C. Pharmacological options </li></ul><ul><li>D. Surgical options </li></ul>Outline
Overview of the Disease ● autoimmune disease ● affects 1% of population ● chronic, systemic, inflammatory ● adverse effects on joints ● psychological, social, and financial effects
Causes ●Viral Infections ●Genetics ●Weakened Immune Systems
Symptoms ●loss of appetite ● fever ● energy loss ● anemia ● side-effects in other parts of the body ● joint swelling and painful movement ● development of rheumatoid nodules on or close to the joints and other joint deformities
Diagnosis Criteria ●morning stiffness ● arthritis in three or more joint areas ● symmetric arthritis ● presence of rheumatoid nodules and rheumatoid factor. Doctors analyze all symptoms, medical history, and lab tests and do a physical examination and radiograph testing. Specialists consider a white-blood cell count and a complete blood-cell count
Who is at Risk? ●Usually found in adults between the ages of 40 and 60. ●Women are affected three times as much as men. ●Children can be affected in the most damaging ways. ● Rheumatoid arthritis has the potential to affect people of any age, and the severity of the disease varies among them.
Parts of a Joint ● joint capsule that separates the joint from surrounding tissue ● cavity formed by the capsule ● a synovial membrane that lines the inside of the cavity ● synovial fluid that lubricates the joint. ● bones and cartilage that are joined together.
Effects on a Joint Effects on the Joint ●synovial lining cells begin to multiply and grow to form a diseased tissue called pannus ● synovial fluid that is supposed to lubricate the joints also undergoes a transformation ● Digestants form in the fluid, and they attack surrounding tissues as well ● the main components of the joints are altered, they are unable to perform their original joint-preserving functions
Systemic Effects ● pathology of the nervous system - leads to sensory loss ● Eye lesions or dry eyes ● skin problems (fragile and bruise easily) ● Lung disease and other cardiopulmonary disorders ● Major body organs such as the spleen and lymph nodes may also be affected as a result of RA
Education Planning ● Patients experience good and bad days. ● patients and family work closely with a physician to obtain a complete understanding of the disease and its nature. ● all activities and rest periods should be planned ● disease could flare at any time due to overworking the joints or extreme physical stress ● Rest cannot be overemphasized. ● Patients may find that they become fatigued easily ● After any period of vigorous activity, a rest period should be planned ● When sleeping, position changes should be in two hour intervals. Emotions, Stress, and Quackery ● relationship between emotions and exacerbations ● stress, such as sporting events and driving in bad whether ● devices and gizmos that claim to cure arthritis ● vitamins and other pills will make a patient disease-free.
Preventing disability and preserving joint function ● plan exercise and develop a routine to help maintain joint function ● Range of motion (ROM) can be preserved through careful evaluation and a healthy exercise program. ● A common type of exercise, Isometric, targets specific muscle groups while avoiding joint motion. ● schedule regular check-ups with their doctor and discuss any concerns openly so that the doctor can best evaluate their condition. Treatment Symptomatic treatment ● applying direct heat to an area of swelling or stiffness ● There is no evidence that these methods alter the progression of the disease in any way. ● hot packs, paraffin wax, heating pads, and whirlpool baths. ● cold packs as an alternative to heat therapy. CAM Methods (Complementary and Alternative Medicine) ● herbal treatments ● vitamins ● minerals ● ointments ● magnets and copper bracelets ● Diets ● praying ● meditation and relaxing activity
Pharmacological and Surgical Options Pharmacological Options ● NSAIDs (nonsteroidal anti-inflammatory drugs) reduce joint pain and swelling, but they do not affect the progression of the disease. ● relieve pain and inflammation. ● DMARDs (disease-modifying antirheumatic drugs) are the basis for most RA treatments due to their reputation for impeding joint destruction. These drugs should be implemented into a combination therapy immediately after diagnosis because joint deterioration begins early on. The patient and physician should make a decision about which DMARD to use based on the severity of the disease. Surgical Options ● Tenosynovectomy will remove the tendon sheaths. ● Synovectomy is performed to remove diseased parts of the synovium before any cartilage destruction takes place. ● Joint arthoplasty involves the replacement of the joint end with man made parts called prosthesis. ● Arthrodesis, a surgical fusion of the bone, has proved very effective in patients with wrist pain.