What Are the 4 Stages of Rheumatoid Arthritis?

What Are the 4 Stages of Rheumatoid Arthritis? 

Inflammation of the tissues surrounding the joints erodes bone, causing the joint to lose its mobility. Treatments are tailored to the individual needs of each patient. DMARDs and non-pharmacological therapies are often prescribed to ease pain. The disease may progress to joint space narrowing, osteoarthritis, or cystic erosions of bone. 

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DMARDs 

Biologic DMARDs are used to treat rheumatoid arthritis in patients with varying stages of the disease. These medications block the action of immune cells called T cells, which contribute to the inflammation of the joints. Biologic DMARDs are used in conjunction with other treatment options, including biologic response modifiers. 

DMARD use among patients with RA has increased dramatically over the past two decades. The development of novel biologic drugs targeting specific components of the immune system has revolutionized treatment of RA. In a previous study of a prospective cohort, the proportion of patients on biologic DMARDs increased from 10% in 1999 to 48% in 2009. This rising prevalence of biologic therapy suggests the need to examine characteristics of these patients and their response to biologic therapy. 

Non-pharmacological therapy 

Non-pharmacological interventions have been used to treat rheumatoid arthritis, a disease caused by the immune system attacking the joints. It can cause stiff, swollen, and painful joints. These interventions can help to reduce pain and improve movement. These interventions can also help with fatigue, which is a common problem in people with rheumatoid arthritis. 

Non-pharmacological therapy for ra can include intra-articular corticosteroids, which act to reduce inflammation in a particular joint. These agents, such as methylprednisolone and triamcinolone, are often effective without affecting an individual’s overall drug regimen. 

Joint space narrowing 

Patients with rheumatoid arthritis may experience joint space narrowing as a result of the disease. It is a permanent condition, but there are ways to manage pain and maintain joint flexibility. For example, anti-inflammatory drugs can alleviate joint pain and swelling. In addition, disease-modifying anti-rheumatic drugs can slow the progression of joint damage. 

Joint space narrowing is caused by the breakdown of cartilage between bone ends. This leads to decreased space in the joint, causing the bones to rub against each other. If this process continues, the bones may grow outward to compensate for the loss of cartilage. 

Cystic erosions of bone 

In the early stages of the disease, bone erosion and cartilage destruction occur rapidly. This leads to limitations in joint range of motion, flexion contractures, and subluxations of articulating bones. The articulating bones lose their alignment, and typical deformities are ulnar deviation of the finger at the MCP joint, hyperextension of the fingers, boutonniere deformities, and carpal bone subluxations. These deformities are often accompanied by swelling of soft tissues. 

Bone erosion is a hallmark of RA, and is relevant to diagnosis and treatment. Recent advances in imaging technologies and new insights into pathophysiology have improved our understanding of bone erosion and its role in RA. New data have changed concepts of pathogenesis, and erosion is now seen as an active process that begins early in the disease. This process is integrally linked to autoimmune synovitis and innate immune mechanisms.