Rheumatoid Arthritis is a self-induced problem by the body. Precisely, it is an autoimmune deficiency that occurs when the immune system attacks human body cells. Immune systems are known to protect the body from bacteria and virus attacks. In extreme situations, the immune system attacks human joints and as a result causes Rheumatoid Arthritis. A Rheumatoid Arthritis victim is likely to have painful, swollen joints. This happens in the tissue lines under the joints. When the immune system mistakenly attacks the joints, the underlying joint tissue thickens and causes pain around the joint.
Moreover, the thickening of the tissues causes the joints to swell. The joints commonly affected by Rheumatoid Arthritis include wrists, hands, elbows, feet, ankles, and knees joint. Notably, the disease is symmetrical. This means that it does not attack one join only but two. For instance, if Rheumatoid Arthritis attacks the right wrist joint, the left is also likely to be attacked.
The incidence of Rheumatoid Arthritis is common amongst women of all ages but has the highest number of patients among women aged between 50 and 60 years. Rarely, men are exposed to this disease. However, unlucky men exhibit this disease at a later age. Moreover, if the disease is common in a family, the offspring from that family, whether male or female are likely to suffer from it. Nevertheless, according to research by the arthritis foundation, many individuals who suffer from Rheumatoid Arthritis have no family history of the disease (Arthritis Foundation). From a global perspective, the disease affects about 1% of the global population. However, the disease is prevalent in the United States. RA affects over 1.29% of the US population (RA Statistics 2013). 860 people per 100000 Americans suffer from Rheumatoid Arthritis. Nevertheless, the numbers had fallen compared to 40 years back when RA patients were approximately 2.1% (RA Statistics 2013). Regardless of this fall, women still exhibit a high occurrence of the disease compared to men.
The pathophysiology process of Rheumatoid Arthritis is complex. As much as medical researchers have tried looking into the disease, it is not completely understood. However, current research establishes that RA occurs in genetically susceptible individuals who have a high tendency to smoke, are traumatized, or have pathogenic infections (Choy 5). Importantly, these behaviors and deficiencies set off autoimmune reactions that lead to the thickening of the tissues and as a result swelling of the joints. Remarkably, the early signs of the disease include hyperplasia and endothelial cell activation that progress to inflammation that cannot be controlled. The last stage of the disease includes bone and cartilage destruction (Choy 8). Some of the cells that play a significant role in the path physiology of RA include fibroblasts, monocellular phagocytes, neutrophils, and CD4 T cells.
Medical practitioners take these individuals through physical examinations to know the symptoms and the prevalence of RA in individuals. The assessments are used to investigate function, swelling, and pain in the upper extremities lower extremities, and cervical spine (Magee and Sueki 25). The function assessment includes evaluating the active motion of the joints. Currently, the physician monitors how individuals can bend or raise an arm. The goniometer is used to measure the range of the motion of the hand. As for the swelling assessment, the physical evaluates the degree of swelling resulting from thickening the inner line of tissues below the joints. This is done by applying pressure to the joint to detect the swelling and is done using a tape measure (Magee and Sueki 26). Lastly, examining pain involves applying pressure to the joint as the patient moves his/her joint, and the doctor notes the pain points during the movement. Ultimately, these physical evaluations help doctors develop treatment plans and medication for the disease.
Evidence-based treatment of Rheumatoid Arthritis is based on the physical assessment doctors have identified from RA patients. Depending on the disease’s prevalence, it may take non-drug or drug treatment approaches. Importantly, the two approaches aim to provide control of RA symptoms, help patients maintain their ability to function, and prevent dames in the joints. Nevertheless, non-drug management approaches for RA include cognitive behavior therapy, exercise, rest, psychological support nutrition and dietary therapy, and education and counseling (RA Treatment Overview). On the other hand, drug treatments include applying symptomatic or disease-modifying treatments. Notably, these treatments are applied to sick individuals based on how severe RA is. One of the essential approaches to RA treatment is patient education. Some of these educational approaches include discussing prognosis and treatment, informing patients of diagnosis, supporting patients with debilitating disease, and advising patients on ways of dealing with RA misconception (RA Treatment Overview).
Lastly, the treatment approaches should be followed by follow-ups on the patients to see their health progress. The follow-up should be based on patients’ episodic, acute, and chronic state. Based on these types of patients, the follow-ups include measurement of the functional ability of the joints and radiographic progression. Notably, episodic patients undergoing drug-free treatment would require less follow-up compared to those experiencing advanced stages of the disease. Most importantly, the follow-ups should address whether the patients are healing.
Work Cited
Choy, E. “Understanding the dynamics: pathways involved in the pathogenesis of rheumatoid arthritis.” Rheumatology, vol. 51, no. Suppl 5, 2012, pp. v3-v11.
Magee, David J, and Derrick Sueki. Orthopedic Physical Assessment Atlas and Video: Selected Special Tests and Movements. Elsevier Health Sciences, 2013.
“RA Statistics 2013.” RheumatoidArthritis.net, rheumatoidarthritis.net/what-is-ra/ra-statistics/.
“RA Treatment Overview.” RheumatoidArthritis.net, rheumatoidarthritis.net/treatment/.
“What is Rheumatoid Arthritis?” Arthritis Foundation | Symptoms Treatments | Prevention Tips | Pain Relief Advice, www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/what-is-rheumatoid-arthritis.php.
