0.25 سم مكعب

التهاب المفاصل الروماتويدي "الأيدي غير المحظوظة"

المتحدث: الدكتور أحمد أبو جمال

Consultant Rheumatologist & Professor Of Joint Disease, Gargash Hospital, DXB

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وصف

Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the joints, often leading to inflammation, pain, and progressive joint damage. The term "The Unlucky Hands" may be used metaphorically to describe the unfortunate impact of RA on the hands, which are commonly affected in this condition.

RA occurs when the immune system mistakenly attacks the synovium, the lining of the membranes that surround the joints. This immune response results in inflammation, which can eventually lead to joint damage and deformities. The exact cause of RA is not fully understood, but a combination of genetic and environmental factors is thought to play a role.

ملخص

  • The talk centers around Rheumatoid Arthritis (RA), humorously referred to as "Romaltoy Dars-Farters," emphasizing the challenges in diagnosis and management despite advancements in understanding the disease's pathogenesis. RA is described as a common rheumatic syndrome affecting a significant portion of the population, characterized by inflammation driven by cytokine conduction leading to cartilage and bone destruction, ultimately causing deformities and functional disability.
  • The speaker highlighted diagnostic challenges including varied presentation patterns, limitations of rheumatoid factor and anti-CCP antibody tests, and the delayed appearance of erosions in conventional X-rays. These factors contribute to delayed diagnosis and treatment, leading to worse outcomes for patients.
  • Advances in imaging techniques, such as ultrasound and MRI, offer improved sensitivity in detecting early erosions and inflammation compared to traditional X-rays. These tools are especially useful in diagnosing seronegative RA, where traditional markers are absent. The adoption of updated ACR/EULAR criteria in 2010 emphasizes early diagnosis and treatment to prevent irreversible joint damage.
  • The "treat-to-target" strategy, aiming for disease remission, has revolutionized RA management. This approach involves frequent monitoring and adjustments to treatment plans to achieve specific targets. Studies have shown the superiority of this strategy over traditional approaches in achieving clinical remission, improving quality of life, and preventing structural damage.
  • Achieving lucky hands involves a more careful examination and evaluation of patients presenting with joint pain. The recommendation is to look for persistent joint pain, morning stiffness, and swelling, even if responsive to NSAIDs, alongside checking the family history. Physicians should be proactive in using advanced imaging and aggressively treat patients to achieve remission and prevent long-term disability.

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