Thursday, September 19, 2013

Rheumatoid Arthritis - Its Signs, Symptoms and Pathophysiology

Rheumatoid arthritis presents with signs and symptoms that are distinguishable from other forms of arthritis. The classical signs it presents make its diagnosis easier and also enables the medical personnel to prescribe the right drugs for its treatment.

The signs and symptoms of this disease therefore include the following:

1. The onset is gradual
2. Stiffness of joints
3. Transient muscular pain
4. Numbness and coldness of extremities
5. Redness, soreness and swelling of some joints
6. Malaise and fatigue
7. Weight loss
8. Subcutaneous nodules over bony prominences
9. Joints of the fingers and toes are first affected. Joints of the elbow, wrist and shoulder later become affected
10. Fingers may become spindle shape with patient unable to make a firm grip
11. Muscular atrophy as a result of lack of use of the muscles
12. Anaemia (aplastic anaemia)
13. Patient appears undernourished and chronically ill
14. There are periods of remissions and relapses

Pathophysiology of Rheumatoid arthritis

Rheumatoid arthritis passes through four stages. The first noticeable stage is the inflammation of the synovial membrane (synovitis), causing congestion and oedema.

The next stage is the formation of pannus. A layer of inflammatory tissue forms in the joint capsule. Fibroblasts, leucocytes, lymphocytes, plasma cells and other materials multiply from the synovial membrane leading to a pannus tissue which invades the cartilage and slowly replace it with tough fibrous tissue.

The disease progresses to the next stage otherwise known as fibrous ankylosis. This involves the conversion of the articular cartilage of the joint into fibrous tissue thereby inhibiting motion of the joint. The final stage is the bony ankylosis. In this stage, the bones of the joint fuse together thereby making mobility impossible.

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