Wednesday, 24 April 2013

Diagnosis and treatment of rheumatoid arthritis

Rheumatoid arthritis, chronic inflammatory rheumatism well-known for making many people disabled.
In a September 2007 report, offers a number of professional recommendations to diagnose and treat this condition.

The diagnosis

Rheumatoid arthritis can become disabling, that is why it is necessary to diagnose as soon as possible to undertake a substantive treatment quickly.
In its recommendations, HAS set out several simple criteria to evoke a diagnosis of rheumatoid arthritis:
Stiffness morning > 30 minutes
> 6 Weeks symptoms evolution duration
Arthritis of at least 3 joints affecting wrists or the metacarpophalangeal and interphalangeal the proximal of the hands
Pain to the pressure of the metacarpophalangeal
Symmetric impairment

If these criteria are met, the physician should then, and this from the first consultation, prescribe examinations for diagnosis. According the HAS, these exams are:
a review of imaging to search for erosion or joint pinch (X-rays of the hands and wrists from the front, feet from the front and 3/4 in size (1/1) and any symptomatic articulation),.
a biological assessment (factor Rheumatoid IgM, CCP, erythrocyte sedimentation rate, protein C reactive (CRP)),
a differential diagnosis: minimum explorations (serum creatinine, blood, urinary test strip, antinuclear antibodies, chest X-ray).

The treatment

Drug treatment

Treatment differs depending on whether it is active without signs of severity or active and severe rheumatoid arthritis for at the outset.

Non-drug treatments

Non-drug treatments should be also considered (physiotherapy, occupational therapy, Podiatry, psychological follow-up...).
In its recommended that "the practice of physical activities in addition to drug treatment should be considered systematically, and not only after surgery.
The doctor promotes the implementation of therapeutic education of the patient. He proposes a social and professional support custom.


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