Rheumatism | Rheumatoid Arthritis

Rheumatism or rheumatoid arthritis is a chronic systemic inflammatory disease that is cause by genetic, autoimmune and viral. Disorder usually starts in early adulthood (20-40 yrs old) and it is more common in women. Commonly involved joints are fingers, wrists and toes. These become painful. There is gradual onset of mild fever and generalized aches and pains. A joint becomes swollen, red, warm, painful and stiff. Structures around joint become inflamed. When fingers are involved grip becomes weaker and becomes white when being exposed to cold environment. In some cases soft nodules develop beneath the skin.

The signs and symptoms of rheumatism are morning stiffness, calcification of fibrous tissue, swan neck in the upper extremities and ulnar deviation. Synovitis with edema is one of the signs and symptoms of rheumatism that is caused by increase of white blood cells or presence of infection that increases the temperature or client will become febrile and manifests chills, anorexia, nausea and vomiting that will lead to body weakness and eventually result in weight loss. Destruction and fibrosis of cartilage is very dangerous for client with rheumatism because the complications will be impaired mobility, tender joints and boutonniere in the thumb.

Rheumatism is the most painful type of arthritis that's why a lot of diagnostic examinations and treatment is present in the medical industry. Radiographic test is done to show the bony erosions, the narrowed joints surfaces. Blood studies or laboratory examinations is performed to determined increase white blood cells and estimated sedimentation rate that will show the presence of infection.

Arthrocentesis is an invasive procedure; a needle is used to aspirate synovial fluid in the joints to observe if there is an ample amount that present in the clients joints. If a medical practitioner will aspirate a cloudy milk or yellowish synovial fluid it is a strong indication of infection.

Management for rheumatism is advice client to immobilize the affected part when in severe pain or complete bed rest is needed. Encourage client to use hot and cold packs to reduce the inflammation and swelling of the affected joints. It should be a well balanced diet. A medication is also part of the regimen to decrease the pain being felt by the client. Non Steroidal anti-inflammatory drugs are the drug of choice to be given to clients such as naproxen, salicylate, Advil, ibuprofen, diclofenac and sulindac. These drugs should be taken with meals because it can cause gastric upset or even ulcer. Bleeding precautions should be practice avoid anti platelet agents such as aspirin with thrombolytic because it will lead to shock particularly hypovolemic and much contraindicated to children less than 18 years of age. Disease modifying ant rheumatic drugs are sulfasalazine and hydroxychloroquine.