 Definition
Incidence
and Prevalence
Morbidity
and Mortality
Risk
Factors:
Protective
Factors
Detection
and Conclusion
References
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Epidemiology
of Adult Rheumatoid Arthritis.
Introduction
Rheumatoid arthritis is a
chronic systematic inflammatory disorder of unknown cause. It affects the
peripheral joints in a systemic manner. Within 10 years of onset it causes
great disability .
Arthritis is the dominant clinical manifestation, involving
many joints, especially those of the hands and feet. The course is
variable, but often chronic and progressive, leading to deformity and
disability.
In most cases of RA, the patient has remissions and exacerbations of the
symptoms.
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This
means that there are periods of time when the patient "feels
good" and times when the patient "feels worse". There
will likely be times that a patient with RA "feels cured".
It is important to understand that there are very few patients that
have complete remission of the disease and it is essential that the
RA patient does not stop the treatment program |
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Methods and definitions
The method of searching the
topic was through internet by medical databases like Pubmed, medical
magazines in science direct.com and http://scholar.google.com (a new
feature of google search engine for searching only academic papers .Its in
beta version)
Keywords used
for searching were Epidemiology of adult rheumatoid arthritis,
Mortality and morbidity of rheumatoid arthritis, Nutrition and
rheumatoid arthritis, Pregnancy and rheumatoid arthritis, Rheumatoid
arthritis in developing countries.
Definitions.
Rheumatoid factor.
The test for rheumatoid factor (RF)
is used to help diagnose rheumatoid arthritis (RA
Environmental factors
The
term ‘environment’ is frequently used to describe all those
susceptibility factors leading to disease that are not
explicable on the basis of an identifiable genetic marker.
1987
Criteria for the Classification of Acute Arthritis of Rheumatoid Arthritis
In 1958 American
college of Rheumatology [1]presents the diagnostic criteria for rheumatoid
arthritis . Then in 1987 it presents another diagnostic criteria. the
reason being "improved clinical knowledge and other forms of
arthritis misdiagnosed as RA are now separately classified"[2]
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Criterion
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Definition
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1. Morning stiffness
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Morning stiffness in and around the joints, lasting at least 1
hour before maximal improvement
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2. Arthritis of 3 or more joint areas
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At least 3 joint areas simultaneously have had soft tissue
swelling or fluid (not bony overgrowth alone) observed by a
physician. The 14 possible areas are right or left PIP, MCP, wrist,
elbow, knee, ankle, and MTP joints
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3. Arthritis of hand joints
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At least 1 area swollen (as defined above) in a wrist, MCP, or
PIP joint
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4. Symmetric arthritis
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Simultaneous involvement of the same joint areas (as defined in
2) on both sides fo the body (bilateral involvement of PIPs, MCPs,
or MTPs is acceptable without absolute symmetry)
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5. Rheumatoid nodules
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Subcutaneous nodules, over bony prominences, or extensor
surfaces, or in juxtaarticular regions, observed by a physician
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6. Serum rheumatoid factor
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Demonstration of abnormal amounts of serum rheumatoid factor by
any method for which the result has been positive in <5% of
normal control subjects
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7. Radiographic changes
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Radiographic changes typical of rheumatoid arthritis on poster anterior
hand and wrist radiographs, which must include
erosions or unequivocal bony decalcification localized in or most
marked adjacent to the involved joints (osteoarthritis changes alone
do not qualify)
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·
· *
For
classification purposes, a patient shall be said to have rheumatoid
arthritis if he/she has satisfied at least 4 or these 7 criteria. Criteria
1 through 4 must have been present for at least 6 weeks. Patients with 2
clinical diagnoses are not excluded. Designation as classic, definite, or
probable rheumatoid arthritis is not to be made.
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Table
no 1 .[2]
International Classification of
Diseases-10 (ICD-10) OF ADULT RHEUMATOID ARTHRITIS.[3]
Adult
rheumatoid arthritis attracts the coding in ICD-10 from M05-M06
M05.3
Rheumatoid
arthritis with involvement of other organs and systems
M05.9
Seropositive
rheumatoid arthritis, unspecified
M06
Other
rheumatoid arthritis
M06.0
Seronegative
rheumatoid arthritis
M06.4
Inflammatory
Polyarthropathy
M06.9
Rheumatoid
arthritis,
unspecified
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