Rheumatoid arthritis (RA) is a “rheumatic disease”, that can affect the organs and systems of the whole body. It is a serious, long-term, and progressive condition, but one in which there are often periods in which the disease does not cause any symptoms. Fortunately, modern treatment can prolong these symptoms-free periods and slow the disease process.

Rheumatoid arthritis is an autoimmune condition, in which the body’s defense mechanism attacks its own tissues. It affects about three times more women than men. It can strike at any stage of life, but it usually becomes apparent between ages 40 and 60.

Symptoms

In RA, joints lubricated by synovial fluid become inflamed – and a large number of the joints in your body, including the facet joints of the vertebrae, are synovial. This inflammation leads to a reduction in mobility and damage to bones and cartilage. In the spine, the cervical (neck) vertebrae are most commonly affected by this condition.

The symptoms of RA tend to come and go, often being inactive for months or even years. This makes the condition difficult to diagnose early. The hands and wrists are often the first to be affected, leading over time to severe deformities.

The disease often affects the cervical vertebrae, leading to pain at the base of the neck as the vertebrae become unable to support the weight of the skull, and so slip bit, leading to deformities and the serious risk of spinal cord compression at the base of the skull.

Compression in other areas of the spine may first become apparent if your gait starts to change. You may also experience weakness and problems in keeping your balance. When the condition is active, there is muscle and joint stiffness, frequently accompanied by tiredness, a raised temperature, and a loss of appetite.

RA can also affect other organs and systems of the body, such as the lungs, kidneys, heart, liver (“Felty’s syndrome), and the eyes (“Sjogren’s syndrome), which often become dry and inflamed.

Rheumatoid Arthritis

What Causes Rheumatoid Arthritis?

Nobody knows for sure. What is clear is that a family history of RA predisposes to it, and there is strong evidence that cigarette smoking, stress, and obesity are all risk factors.

It is thought that, especially when risk factors are present, a viral or bacterial infection may trigger an autoimmune response in which your body’s defensive immune system starts to target your body’s own tissues.

Figuring Out What’s Wrong

A doctor may first suspect RA after looking at your joints to see whether they are swollen, twisted in any way, or tender; stiffness (characteristically in the morning) and decreasing mobility are also key indicators. The relative numbers of small and large joints affected are an important part of the diagnosis. Blood samples are also taken. In about 80 percent of people who have RA, an antibody – that is, a protein that destroys material identified as foreign – called “rheumatic factor” is found, but some people who have this antibody in their blood do no have RA.

Fixing Rheumatoid Arthritis

The earlier a diagnosis is made and treatment can start the better in order to reduce the risk of irreversible joint damage.

The pain of RA can be relieved by oral medication, physiotherapy or injection.

Call +65 64712674 for an appointment to treat Rheumatoid Arthritis today. Same day appointment.

Rheumatoid arthritis is a systemic disease that affects multiple joints in the body. Unlike osteoarthritis, which is due to age and wear, rheumatoid arthritis is the result of a disease process throughout the entire body. As a rule, multiple rather than single joints are affected.

Rheumatoid arthritis usually develops between ages 30 and 60 years, but can also present earlier as juvenile arthritis in childhood. Women are more than twice as likely to have the disease as men. There may be a genetic predisposition to getting the disease. Some evidence suggests that rheumatoid arthritis may be an autoimmune phenomenon, but it is unclear as to what triggers the immune response.

The source of the disease is the synovium, the lining tissue of the joint. In a healthy joint, synovium provides lubricant and nutrition to the surrounding tissues. In rheumatoid arthritis, the synovium becomes inflamed and proliferates. The resulting tissue layer is called pannus. Pannus invades the joint surfaces and causes destruction of the cartilage and underlying bone. Inflammatory factor in the synovial fluid may also damage the cartilage.

The diagnosis of rheumatoid arthritis is based largely on clinical factors, but blood tests may also be positive. The rheumatoid factor, an antibody found in blood, is present in most patients with rheumatoid arthritis. The erythrocyte sedimentation rate (ESR) is a less specific test that is often elevated in RA.

The American College of Rheumatology lists seven criteria for the diagnosis of rheumatoid arthritis. Four of these have to be positive in order to confirm the diagnosis. The seven criteria include:

  • Morning stiffness
  • Arthritis in at least three joints
  • Arthritis in the hands
  • Joint involvement on both sides of the body
  • Positive rheumatoid factor
  • Rheumatoid nodules
  • X-ray changes consistent with rheumatoid arthritis

Joints with rheumatoid arthritis are warm, swollen, and sometimes contracted. Other clinical features include rheumatoid nodules beneath the skin and tenosynovitis or thickening of the tissue that covers tendons.

The hip is one of many joints in the body that can be affected by RA. Like OA, the onset is gradual. The main symptoms are pain, stiffness, loss of motion, and limping. Usually the diagnosis of rheumatoid arthritis is known to the patient by the time symptoms present in the hip.

The surgical treatment for RA is the same as for OA. If the joint is destroyed total hip replacement is required.

Rheumatoid bone is often osteoporotic and of poor quality. This may affect the choice of components and the type of fixation. If the bone is very soft it may not be possible to press fit components and cement may be required. Patients with rheumatoid arthritis are not candidates for resurfacing because of the risk of bone collapse and failure.

Call (+65) 6471 2674 (24 Hour) to see our specialist regarding your rheumatoid arthritis hip joint today.

Knee Replacement X-ray

Arthroplasty is a surgical procedure done to reconstruct or replace a diseased joint. Arthroplasty for rheumatoid arthritis is done to correct the deformity or restore the function to the joint. Bones in a joint can be replaced with metal or plastic parts.

Knee Replacement X-ray

What To Expect After Arthroplasty for Rheumatoid Arthritis

Recovery after arthroplasty is gradual. You may need to stay in the hospital for 2 days and the next day after the surgery, you will be able to walk with the help of walking aids. Depending on the the joint operated, post operative rehabilitation program will take a few weeks.

Why Arthroplasty for Rheumatoid Arthritis Is Done

Arthroplasty for rheumatoid arthritis will provide pain relief and improve the range of movement of the joint to a certain extent.

Arthroplasty for rheumatoid arthritis is considered when:

  • Symptoms can no longer be controlled with medicine, joint injections, physical therapy, and exercise.
  • Pain from rheumatoid arthritis can no longer be tolerated.
  • You are not able to do normal daily activities.
  • Narrowing of the joint space or wearing away of the cartilage and bone is causing severe pain or reduced range of motion.

How Well Arthroplasty Works for Rheumatoid Arthritis

Arthroplasty can help in reducing the pain and restore  the function of the joint to allow you to resume to your normal activities.

What are the Risks of Arthrosplasty

The risks of arthroplasty include risks of a surgery and anaesthesia, the risks are small:

  • Infection
  • Loose joints

What To Think About For Arthroplasty For Rheumatoid Arthritis

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An important factor to the success of arthroplasty also depends on the person’s commitment to post operative rehabilitation.

Call +65 6471 2674 (24 hr) for an appointment to see our orthopaedic surgeon to discuss arthroplasty for rheumatoid arthritis.

Knee arthroscopy external view

Arthroscopy is a keyhole surgery whereby a mini camera is inserted into the joint through small cuts in the skin, allowing the surgeon to see the inside of the joint. Instruments are inserted through other small incision to repair the joint. Arthroscopy for rheumatoid arthritis can help to improve the symptoms to much extent, but it does not cure the underlying rheumatoid arthritis condition.

Knee arthroscopy external view

What To Expect After Arthroscopy?

Arthroscopy is usually done as a day surgery, there is no need to stay overnight in the hospital. Three day’s later after the surgery, the dressing will be changed in the clinic. For knee, hip or ankle arthroscopy, you may need to use crutches if you are not able to weight bear.

Why Arthroscopy Is Done?

Arthroscopy for rheumatoid arthritis is done to treat large joints such as hip, shoulder and knee. The procedure of an arthroscopy include:

  • Cleaning and removing debris from the joint.
  • Removing loose bodies (pieces of bones or cartilage floating) from the joint.
  • Shave out rough or irregular joint surfaces.
  • Removal of inflamed tissues  in the joints.

Arthroscopy is not suitable for severe damage to the joint.

How Well Does Arthroscopy Works?

Arthroscopy provides pain relief to a certain extent and sometimes it can help to improve the range of movement.

Risks of Arthroscopy

As with all other surgery, there is a risk in arthroscopy. However, the risk is small such as infection or bleeding in the joint.

What To Think About Should You Decide for Arthroscopy

Arthroscopy helps for many conditions as it provides a window for the surgeon to view the actual condition of the joint and the surgeon can perform repair at the same time. Bear in mind, arthroscopy for rheumatoid arthritis can help with the symptoms but it does not cure the underlying rheumatoid arthritis disease.

Call (+65) 6471 2674 (24hr) to fix an appointment to see our orthopaedic surgeon to discuss arthroscopy for rheumatoid arthritis in detail today.