This week, let’s learn more about one of the most common diseases among Filipinos, which is called rheumatoid arthritis (RA).
RA is generally characterized with chronic inflammatory synovitis and potentially disabling polyarthritis. It may have extra-articular/systemic manifestations.
In contrast to osteoarthritis (OA) which starts off as a cartilage problem, RA is predominantly a synovitis, with the participation of several inflammatory cells and mediators such as cytokines, forming a sheet of inflammatory reaction with fibrosis, called pannus.
The criteria to determine the existence of RA would include the following:
1. Morning stiffness.
2. Arthritis of three or more joints.
3. Arthritis of hand joints.
4. Symmetric arthritis.
5. Rheumatoid nodules.
6. Serum rheumatoid factor.
7. Radiographic changes
The indicators mentioned should be present for at least 6 weeks before RA can be diagnosed.
Disease- modifying anti-rheumatic drugs or DMARDs are a mainstay in the management of RA.
DMARDs are primally instituted by a specialist: The role of the primary care physician is to monitor and recognize side-effects of the drugs.
It is fundamental to establish the diagnosis of RA. Non steroidal anti-inflammatory drugs (NSAIDs) constitute the first line of therapy, even while observing the patient prior to the required 6 weeks duration of symptoms for RA.
Patient education and physical therapy are important parts in the treatment for RA.
it is best to refer to the rheumatologist, who will reassess the patient and likely start a DMARD or a combination of DMARDs. The patient nay be endorsed back to the primary care physician for monitoring.
The team approach is important in the treatment of RA as the patient, specialist and primary care physician should be involved in the treatment process.