Rheumatoid arthritis is an inflammatory, chronic disease that affects multiple joints. Some of the common characteristics includes periods of inflammation/exacerbation then remission. Usually the small joints are affected first, with a symmetrical joint involvement e.g. right and left fingers simultaneously etc.
Rheumatoid Arthritis Disease Process
Synovial membrane thickens, becoming increasingly vascularised and filled with inflammatory cells. This build up of tissue is very aggressive, and can cause:
- erosion of cartilage and subchondral bone
- infiltrates tendon sheaths and disrupts its mechanisms, limiting gliding effect, and can lead to tendon rupture
- goes into the space of connective tissues
- nerve compressions of the sensory or motor nerve especially in tight compartments
This results in pain, joint instability, contractures, weakness of the muscles and even deformity or subluxation. There is usually a varying degrees and levels of damage, pain and functional levels. The perception and actual damage can determine the ultimate function and mobility of each individual. Patients with better pain tolerance and education and hope usually end up with better results and function.
Phases Of Rheumatoid Arthritis Disease
There are three phases of rheumatoid arthritis: acute, sub-acute and chronic. Their characteristics are:
Acute: lots of inflammation, swelling, pain in joints, elevated temperature
Sub-acute: lesser activity and easier to be controlled by medication, more stable but demonstrates that disease is progressing
Chronic: during this stage, the disease is no longer active, but at this point there will be residual biomechanical problems in the joint will cause pain, instability or stiffness