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Diagnosis and Treatment of Rheumatoid Arthritis

[29 May 2012 | No Comments | | Author: ]
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Treatment of any disease is customized to the disease itself, and this is never more true than dealing with individuals who suffer from rheumatoid arthritis.

Rheumatoid arthritis is an immune disease where the body somehow is triggered to attack itself. While there is no known cause and scientists are unaware of any particular trigger or genetic link, the outcome remains the same.

In order to customize the treatments the diagnosis must be accurate. The first step to identify any disease is a physical examination and thorough medical history. During a physical examination to dodge a look for telltale rheumatoid nodules in the areas of pressure such as the elbows and fingers.

She will also vote for redness, tenderness, swelling and heat in the joints. The physician will use a thorough medical history to determine most family relationships, past medical history and families and current injuries or illnesses. In order to complete the diagnosis the doctor may order blood tests and will probably do some imaging studies.

Once the diagnosis of rheumatoid arthritis is confirmed your primary care physician will often refer to a rheumatologist as standard practice. This is a doctor who has received special training and education in the treatment of arthritis and has taken and passed certification Board exams.

Some doctors will claim they are Board eligible but this only means they have passed their initial tests become a doctor but haven’t yet taken the testing to become a rheumatologist.

The rheumatologist will often complete the diagnosis, request further blood tests and imaging studies as a baseline prior to treatment protocols, evaluate the progression of the disease and subsequently prescribe a treatment plan for the individual.

Because the symptoms of rheumatoid arthritis are usually symmetrical, although not always, diagnosis can be more difficult. If there is inflammation in only one or two joints the doctor may use arthrocentesis to rule out infection or gout. The presence of nodules at the elbows were fingers will also make the diagnosis much easier.

Blood testing will often include rheumatoid factor, which is an antibody in the blood of 60 to 80% of patients who have rheumatoid arthritis. Most patients with RA also have the Citrulline antibody in their blood and this is tested when individuals have unexplained inflammation and the physician feels it may be early stages of RA. Anti-nuclear antibodies (ANA) are also thought to be present in the early stages of rheumatoid arthritis.

Another blood tests which is important, not only for the diagnosis of room and toward arthritis but also to track the progression of the disease and the efficacy of the treatment protocols, is these sedimentation rate. This is the rate at which the blood cells fall to the bottom of the tests to once the blood is drawn.

This rate is faster during flareups and when inflammation is high and slow were when the disease is in relapse. Another test to used to measure the amount of inflammation in the body is C-reactive protein.

Unfortunately, there is no conclusive tests for rheumatoid arthritis. In fact blood tests considered above (rheumatoid factor, c-reactive proteins, sedimentation rate and ANA) can be abnormal in other autoimmune diseases so these tests are used in combination with others to conclusively diagnose rheumatoid arthritis.

The goals for treatment of rheumatoid arthritis is to reduce the inflammation and pain as well as maximize the function of the individual. At this time there is no cure for this disease although studies have shown that early aggressive treatment will improve function and decrease progression.

Individuals who receive optimal treatment protocols will address medications, exercise, rest, joint strengthening, joints protection, and patient and family education. Treatment will be customized to each individual and based on the progression of the disease, the types of joints involved, the age of the individual, their occupation, general health and the core operation of both the patient and family.

Medications are broken down into two separate categories. The first-line drugs are anti-inflammatory medications such as aspirin, ibuprofen and corticosteroids. These are fast acting drugs and are used to decrease inflammation, the pain and improve the swelling and discomfort.

Most patients also received second line drugs which are called Disease Modifying Antirheumatic Drugs (AMADs) which are slower acting and used to promote remission of the disease and decrease the progression. These drugs include methotrexate, gold and hydroxycholoquine.

Patients and physicians are also turning to other treatment modalities such as fish oil which has anti-inflammatory effects on the body. Some individuals find pain relief from taking Tylenol and other research has shown promising results using antibiotics.

The physician will also recommend that the patient receives physical therapy to teach them exercises to help strengthen the muscles that support the joints as well is using heat or cold packs to help decrease the discomfort.

Rheumatoid arthritis has a variety of degrees of severity in individuals and treatment has improved significantly over the past several years. While the outcome may be the same for each individual with appropriate treatment and aggressive managements many patients can delay this progression for years. As research continues to move treatment plants foreword researchers believe they are closer to finding the trigger that initiates the immune cascade which results in rheumatoid arthritis.

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