Rheumatoid Arthritis is a self-induced problem by the body that. Precisely, it is an autoimmune deficiency that occurs when human body cells are attacked by the immune system. 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 causing 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 cause the underlying joint tissue to thicken and cause pain around the join. Moreover, the thickening of the tissues causes the joints to swell as well. The joints that are commonly affected by Rheumatoid Arthritis include wrists, hands, elbows, feet, ankle, and knees joint. Notably, the disease is symmetrical. This means that it does not attack one join only but two. For instance, if the right wrist joint is attacked by Rheumatoid Arthritis, the left is also likely to be attacked.
The incidence of Rheumatoid Arthritis is common amongst women of all age but has its highest numbers of patients among women aged between 50 and 60 years. Rarely, men are exposed to this disease. However, the unlucky men exhibit this disease in their late ages. 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 arthritis foundation, many individuals that suffer from the Rheumatoid Arthritis have no family history of the disease (Arthritis Foundation). From a global perspective, the disease affects about 1% of global population. However, the disease is prevalent in the United States. Precisely, 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 high occurrence of the disease compared to men.
The pathophysiology process of Rheumatoid Arthritis is complex. In as much as medical researchers have tried looking into the disease, it is not completely understood. However, current research establishes that RA that occurs in genetically susceptible individuals who have a high tendency of smoking, are traumatized or have pathogenic infections (Choy 5). Importantly, this behaviours and deficiency set off autoimmune reactions that lead to 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 destructions (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.
To know the symptoms and the prevalence of RA in individuals, medical practitioners take these individuals through physical examinations. 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 active motion of the joints. At this moment, 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 evaluate the degree of swelling resulting from the thickening of 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, examination of pain involves applying pressure to the join as the patient moves his/her joint as the doctor notes down the points of the pain during the movement. Ultimately, these physical evaluations help doctors to come up with treatment plans and medication for the disease.
Evidence-based treatment of Rheumatoid Arthritis is based on the physical assessment that doctors have identified from RA patients. Depending on how prevalent the disease has been, it may take non-drug or drug treatment approaches. Importantly, the two approaches aim at providing control of RA symptoms, help patients maintain the ability to function and preventing dames to the joints. Nevertheless, non-drug management approaches of RA include cognitive behaviour therapy, exercise, rest, psychological support nutrition and dietary therapy and education and counselling (RA Treatment Overview). On the other hand, drug treatments include applying symptomatic or disease-modifying treatments. Notably, these treatments are applied based on how severe RA is, too sick individuals. One of the essential approaches to RA treatment is patient education. Some of this education 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 follows up should be based on the episodic, acute and chronic state of patients. Based on this 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 or not.
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.