~Characteristics, diagnosis, and treatment of rheumatoid arthritis
My hands are stiff and difficult to move in the morning, my finger joints are swollen and painful, my shoes don't fit anymore..."
Those who continue to have these symptoms may have rheumatoid arthritis (RA).
Rheumatoid arthritis causes inflammation of the tissue called "synovium" in joints,Autoimmune disease that leads to pain, swelling, and eventually deformation and destruction of jointsIt is. Early diagnosis and appropriate treatment can reduce progression and preserve long-term joint function.
In this issue, we will discuss the symptoms, tests, and treatment of rheumatoid arthritis and what we can do to help.
What is rheumatoid arthritis?
Rheumatoid arthritis is,A disease in which the immune response that is supposed to protect the body mistakenly attacks its own jointsIt is. The center of inflammation is the "synovium," from which inflammation spills over into the surrounding cartilage and bone, eventually causing joint destruction and deformity.
- The prevalence in Japan is Approx. 0.6-1.01 TP3T (700,000-1.2 million)
- More common in women, especially those in their 30s to 50s
- Genetic and environmental factors (smoking, infection, etc.) contribute to pathogenesis
[Main symptoms
Joint symptoms (most common in the early stages)
- Symmetrical joint swelling and pain
- especiallyWrist, finger (MP and PIP joints) and toe joints
- DIP joints (joints at the tips of fingers) are basically free of symptoms
- Morning stiffness (often lasting more than 30 minutes)
- Joint deformities (swan neck deformity, buttonhole deformity, big toe deformity, etc.)
Extra-articular symptoms (systemic symptoms seen in advanced cases)
- Interstitial pneumonia, pulmonary fibrosis
- Sjogren's syndrome (dry eye and xerostomia)
- Amyloidosis, epicarditis, anemia, etc.
Joint inflammation progresses as follows
- initial: swollen synovium (no bony changes on x-ray)
- chronic phase: Cartilage destruction progresses,Bone erosion and narrowing of joint clefts
- terminal (e.g. cancer, disease, etc.)Bone destruction progresses,Joint adhesion and loss of mobility
[Inspection
The clinic performs the following tests to diagnose rheumatoid arthritis
Image Inspection
- X-rayBone erosion and joint deformity are confirmed.
- Echo (ultrasound) examinationReal-time evaluation of synovial swelling and joint fluid retention.It is useful for early detection of inflammation.
Blood test
- Inflammatory response (CRP, erythrocyte sedimentation)
- Rheumatoid factor (RF), anti-CCP antibody(Specific to rheumatoid arthritis)
- MMP-3 (matrix metalloproteinase-3): markers that reflect the progression of joint destruction
Diagnostic Criteria
The diagnosis is based on the "2010 ACR/EULAR Classification Criteria" and is determined comprehensively after excluding other arthritis.
Treatment
The treatment centers onMedication + RehabilitationIt is.
Drug Therapy
- Methotrexate (MTX)Immunosuppressants: first-line immunosuppressants
- a biological (i.e. a biological drug, vaccine, etc.)(e.g., anti-TNFα antibody, IL-6 receptor antagonist): added according to symptoms and progression
- JAK inhibitor: Oral drugs introduced in recent years (for severe cases or as an alternative to biologics)
- NSAIDs (pain relievers) and steroidsSymptom control: used for symptom control
In recent years, due to advances in these therapies,Early treatment prevents joint destruction and aims for remission (a state in which symptoms disappear).It is now possible to
Rehabilitation (our clinic's feature)
- thermotherapy: Relieves muscle tension and improves blood flow
- Joint range of motion trainingRehabilitation to prevent stiffening of joints
- Rheumatism exercises using sticks and towels
- Stretching and light muscle trainingPrevention of progression and improvement of daily activities
*During the acute phase when inflammation is strong, it is important to "rest the joints" without forcing them to move.
Surgical treatment
When joint destruction progresses and functional improvement is difficultSurgical treatment such as joint replacementwill be considered.
Examinations and treatments available at Ikejiri-Ohashi Sera Clinic
Our clinic provides rheumatoid arthritis care under the following system:
Inspection
- Early evaluation with physical examination, echo, and x-ray
- Blood tests for inflammation, antibodies, and bone destruction markers
Treatment
- Drug therapy (including MTX and biologics) in collaboration with specialists
- Rehabilitation programs according to acute and chronic phases
- Attention to extra-articular symptoms and systemic management including collaboration with other departments
According to each patient's symptoms, progression, and living situation,Optimal treatment planning and ongoing follow-upWe will do so.
Summary
Rheumatoid arthritis can be diagnosed and treated at an early stageDiseases that can prevent progression and deformityIt is.
If you feel that your joints have been stiff lately, or your hands are swollen and difficult to move,Do not leave it untreated, see a doctor as soon as possible.is recommended.
In this clinic,Consistent services from diagnostic imaging, blood tests, rehabilitation, and drug treatment are available.It is.
If you have any symptoms of concern, please contact us.
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