Rheumatoid arthritis is a chronic systemic inflammatory disease of unknown cause that primarily affects the peripheral joints in a symmetric pattern.
RA causes joint destruction and thus often leads to considerable morbidity and mortality.
Why do people Get RA ?
- An infectious etiology has been speculated
- Associated with a number of autoimmune responses
- Whether autoimmunity is a secondary or primary event is still unknown
- RA has a significant genetic component
Frequency :
The worldwide incidence of RA is approximately 3 cases per 10,000 population
Mortality/Morbidity:
- Daily living activities are impaired in most patients
- Life expectancy for patients with RA is shortened by 5-10 years
Signs and Symptoms:
- Morning stiffness
- Arthritis of 3 or more joint areas
- Arthritis of hand joints - At least one swollen area
- Symmetric arthritis with simultaneous involvement
- Rheumatoid nodules
Progression of RA :
Stage 1 (early RA)
- No destructive changes observed on x-ray
- Radiographic evidence of osteoporosis possible
Stage II (moderate progression)
- Radiographic evidence of periarticular osteoporosis with or without slight subchondral bone destruction
- Slight cartilage destruction possible
- Joint mobility possibly limited; no joint deformities observed
- Adjacent muscle atrophy
- Extra-articular soft tissue lesions (eg, nodules, tenosynovitis)
Stage III (severe progression)
- Radiographic evidence of cartilage and bone destruction in addition to periarticular osteoporosis
- Joint deformity
- Extensive muscle atrophy
Stage IV (terminal progression)
- Criteria of stage III
- Fibrous or bony ankylosis - stiffness of a joint due to abnormal adhesion and rigidity of the bones of the joint
Remission:
Remission of RA - Five or more of the following conditions present for at least 2 consecutive months:
- Duration of morning stiffness not exceeding 15 minutes
- No fatigue
- No joint pan
- No joint tenderness or pain with motion
- No soft tissue swelling in joints or tendon sheaths
- ESR of less than 30 mm/h for a female or less than 20 mm/h for a male
Lab Studies:
No pathognomonic test is available to help confirm the diagnosis of RA. The diagnosis is made using clinical, laboratory, and imaging features. Clinicians will analyze the following:
- Markers of inflammation, such as ESR and CRP
- Synovial fluid analysis
- Rheumatoid factor - Present in approximately 60-80% of patients with RA over the course
- Antinuclear antibodies - These are present in approximately 40% of patients with RA
Treatments:
Disease-modifying antirheumatic drugs:
- Leflunomide (Arava)
- Methotrexate
- Sulfasalazine
- Etanercept (Enbrel)
- Infliximab (Remicade)
Nonsteroidal anti-inflammatory drugs
Analgesics
Glucocorticoids
Immunomodulators:
- Anakinra (Kineret)
- Abatacept (Orencia)
Welcome to our blog which features great information about common foot problems. We see feet of all ages in our practice, Shenandoah Podiatry, located near Roanoke Virginia.
Tuesday, November 23, 2010
Monday, November 22, 2010
Shoe Advice from the APMA
A Shoe for Every Sport
Shoes, shoes, and more shoes. There seems to be a shoe designed for every sport out there. But there’s a method to the madness. Sport-specific shoes really can change your game. See the tips below to learn why the shoe you choose could make or break your day on the court or field.
Basketball — Whether you’re making the perfect pass or
finishing off the high-flying dunk, basketball shoes have
several features that will help you prevent injury.
• A thick, stiff sole gives support while running and landing
from jumps.
• High ankle construction supports the ankle during
quick changes in direction. A basketball shoe should
have the strongest support on either side of the ankle.
Racquetball/Tennis — On the surface, court shoes for tennis and
racquetball may look like any other athletic sneaker, but it’s
what’s on the inside that makes the difference.
• A court shoe supports both sides of the foot because of all
the quick lateral movements and weight shifts in court sports.
• It provides a flexible sole for fast changes of direction.
• It has less shock absorption than a running or basketball
shoe.
Running — The running shoe is perhaps the most personal and intricate of all athletic shoes. Every runner has different needs and there
are a multitude of choices out there.
• A running shoe must provide maximum shock absorption to help
runners avoid ailments such as shin splints and knee pain.
• The shoe should control the way your heel strikes the ground, so
the rest of your foot can fall correctly.
• Know your foot type (high, medium, low arch) so you can get the
shoe with the right support for your foot.
Shoes, shoes, and more shoes. There seems to be a shoe designed for every sport out there. But there’s a method to the madness. Sport-specific shoes really can change your game. See the tips below to learn why the shoe you choose could make or break your day on the court or field.
Basketball — Whether you’re making the perfect pass or
finishing off the high-flying dunk, basketball shoes have
several features that will help you prevent injury.
• A thick, stiff sole gives support while running and landing
from jumps.
• High ankle construction supports the ankle during
quick changes in direction. A basketball shoe should
have the strongest support on either side of the ankle.
Racquetball/Tennis — On the surface, court shoes for tennis and
racquetball may look like any other athletic sneaker, but it’s
what’s on the inside that makes the difference.
• A court shoe supports both sides of the foot because of all
the quick lateral movements and weight shifts in court sports.
• It provides a flexible sole for fast changes of direction.
• It has less shock absorption than a running or basketball
shoe.
Running — The running shoe is perhaps the most personal and intricate of all athletic shoes. Every runner has different needs and there
are a multitude of choices out there.
• A running shoe must provide maximum shock absorption to help
runners avoid ailments such as shin splints and knee pain.
• The shoe should control the way your heel strikes the ground, so
the rest of your foot can fall correctly.
• Know your foot type (high, medium, low arch) so you can get the
shoe with the right support for your foot.
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