ICD code for rheumatoid arthritis. Rheumatoid arthritis. Juvenile rheumatoid arthritis

Origin of systemic disease

In ICD 10, rheumatoid arthritis is listed under the code M06. The abnormal work of the immune system of the patient's body is taken as the basis for the occurrence of the disease. The body is made up of cells whose functions are based on the protection of the immune system. Protective cells begin to be produced after the infection, but instead of destroying the microorganisms that triggered the infectious disease, they begin to attack healthy cells, destroying them. The damage to the cartilaginous tissues of the joints begins, which leads to irreversible destruction in the patient's body.

The codification of microbial 10 is necessary only for doctors, not many patients understand and understand it. Why is it necessary? Let's say a patient is admitted to the hospital with acute pain, and his attending physician is not in place. Taking a card where it is written - rheumatoid arthritis code M06 according to microbial 10, the medical staff knows the patient's medical history, why severe pain, and how to act in this or that case. That is why classification is important for doctors.

Health care has provided for all the nuances in advance, even if they are insignificant, but it is very convenient, especially for the hospital staff. After all, the patient is not always able to explain why he is sick.

Varieties of the disease of the musculoskeletal system

Rheumatoid arthritis is of several types:

There are cases when people with identical symptoms are assigned to different categories of the disease. The nature of the course is different, the degree of the disease can also be different, but the signs are the same.

The clinical picture of the disease in all varieties is largely similar. The main types of symptoms in all classifications of the disease:

Arthritis microbial 10 is a classification of diseases according to generally accepted international standards, the last 10 viewing, in which arthritis is divided into groups according to etiology, course and concomitant ailments and signs.

For patients, in fact, this division into classes will not say anything, but for doctors, this classification is very important. Such a list is provided primarily for medical workers. When making a diagnosis, prescribing tests and determining subsequent therapy, it is important to follow generally accepted norms and designations.

Arthritis code mkb 10

For example, the inscription - arthritis of the joints, microbial 10 indicates that the patient has a disease of the musculoskeletal system and changes in the connective tissue of the joints. Therefore, according to the generally accepted worldwide classification of diseases, it is assigned a specific code and number in the rubric.

This is necessary for the medical staff also to ensure that there are no oversights in data processing and reporting. This classification is used worldwide. This is convenient when maintaining documentation in electronic form on a computer.

Rheumatoid arthritis in microbial 10 is designated M06, but separate subspecies are also distinguished:

Rheumatoid arthritis according to mcb 10 in patients

Symptoms of reactive arthritis mkb 10

Such arthritis can be classified as gouty arthritis according to microbial 10. This will happen if the following is found in the medical history and during the tests:

If there is a diagnosis correctly made by a qualified specialist, the prognosis for a speedy recovery is always high.

The fight of medicine with arthritis mkb 10 and success in treatment

Reports and other paperwork have not been canceled, so this ordering of diseases simplifies the work of medical personnel. Health officials now have more time for patients in need. MKB has reduced and facilitated business management in the medical sector.

For the patient, it does not matter, in fact, what is written in the medical extracts, what subspecies of the disease was revealed in him. It is much more important for a person who comes to the hospital with problems in the body to receive adequate advice, prescriptions, instructions.

The international practice of classifying diseases met all expectations. It has become easier for doctors to treat. In the very developed countries of the world, this has been used for a long time. In the post-Soviet space, this process is only partially taking place. Poor funding of the medical sector is the reason why most hospitals are not equipped with computers.

But it is always better to stay away from medical institutions and not experience all the modern delights of medical care. The rules remain unchanged, the observance of which will save you from all kinds of arthritis, rheumatism and gout.

You need to take care of your body and spirit, adhere to a balanced diet, temper the body, strengthen the immune system, beware of psychological and physical overload, exercise moderately. In this case, no diseases from the generally accepted world classification will be scary.

ICD-10 classification and codes for arthritis of the knee

Classification, incidence rate

In ICD-10, arthritis has a code from M00 to M25. The exact code is set depending on the underlying cause of the disease. In the international classification of diseases, various forms of arthritis are distinguished. The knee joints are very commonly affected. There are 3 forms of this pathology:

The incidence rate of arthritis is 9.5 cases per 1000 people. The risk group includes women aged 40 to 50 years. The knee joint provides flexion of the lower extremities at the knee, which facilitates movement. In severe cases, in the absence of timely treatment, arthritis of the knee joint can cause disability. Do not confuse this disease with deforming osteoarthritis. Arthritis most often develops against the background of another disease of infectious etiology.

This disease can occur in acute, subacute and chronic forms. In the first case, purulent inflammation of the knee joint may develop. In the chronic course of the disease, cartilage tissue suffers. Perhaps the development of ankylosis, contractures. The joint becomes deformed, making it difficult to move the limb. The knee joint may be affected in isolation or polyarthritis occurs.

Why does inflammation occur?

An experienced doctor should know not only the code of the disease, but also the causes of its occurrence. Arthritis of the knee joint occurs for the following reasons:

• against the background of circulatory disorders;
• against the background of infectious diseases;
• against the backdrop of injury.

The most commonly diagnosed is rheumatoid arthritis. The exact cause of its occurrence has not been established. Possible provoking factors: infectious diseases (rubella, herpes, hepatitis), genetic predisposition, environmental factors (stress, occupational hazards, body intoxication). Arthritis can be primary or secondary. Primary inflammation is caused by trauma, infection, decreased immunity. Often the knee joint becomes inflamed against the background of gonorrhea, tuberculosis, dysentery. Secondary forms of the disease develop against the background of blood diseases, sarcoidosis, osteomyelitis.

Clinical manifestations

Symptoms of inflammation of the knee joint are few. The following symptoms are most often observed:

• pain syndrome;
• soreness in one or both knees;
• swelling;
• knee deformity;
• rapid fatigue while walking;
• stiffness in the limbs;
• local increase in body temperature;
• redness.

The severity of the pain syndrome depends on the stage of the disease. The pain is most often worse in the evening and in the morning. In severe cases, pain disturbs a person at night, making it difficult to sleep normally. Deformity of the knee does not occur immediately. Bone or cartilage growths (exostoses) may be observed.

Characteristics of rheumatoid arthritis

According to the ICD - 10 arthritis is rheumatoid. This pathology occurs in 1-2% of the population. The disease has an autoimmune nature. At the same time, against the background of exposure to provoking factors, the cells of the immune system begin to attack the tissues of the joint, causing inflammation. Often, rheumatoid arthritis is formed after suffering measles, mumps, herpes. The symptoms are not specific. In rheumatoid arthritis, extra-articular manifestations are often observed. These include the formation of rheumatoid nodes, weight loss, myocarditis, pleurisy, kidney damage.

The juvenile form of the disease occurs in children and adolescents. One of its varieties is Still's disease. With Still's disease, not only the joints are affected, but also the organ of vision. In this situation, the development of iridocyclitis, cataracts is possible. Rheumatoid arthritis is dangerous for its possible complications. These include anemia, amyloidosis of the kidneys, changes in blood counts (decrease in white blood cells and platelets), damage to the kidneys and heart.

Diagnostic and therapeutic measures

Diagnosis of arthritis of the knee joint is not difficult. The main method is X-ray examination. It is carried out in 2 projections. The radiograph shows signs of osteoporosis, the presence of bone defects, narrowing of the gap in the joint area. Sometimes dislocations or subluxations are found. This indicates a chronic inflammatory process. Other diagnostic methods include history taking, knee palpation, blood tests, ultrasound of the knee joint, scintigraphy, tomography, arthroscopy.

The disease is treated with anti-inflammatory drugs.

The latter are steroidal and non-steroidal. The group of NSAIDs includes Ibuprofen, Diclofenac, Aspirin. The course of treatment with these medicines is very long. Glucocorticoids are used only in severe cases. If the rheumatoid nature of inflammation is detected, treatment may include plasmapheresis (blood purification). In case of ineffectiveness of anti-inflammatory drugs, basic agents (Chloroquine, D-penicillamine) are prescribed.

In the remission phase with a mild degree of inflammation, physiotherapy can be performed. Used electrophoresis, phonophoresis. For a speedy recovery, sanatorium treatment is recommended. If knee inflammation is caused by other diseases, specific therapy is prescribed.

Thus, ICD-10 arthritis of the knee joint in most cases has an infectious or traumatic nature. Treatment should be carried out in the early stages, otherwise the deformation of the joint is possible.

Bibliography

1. Russian medical journal - http://www.rmj.ru/;

2. Journal "Consilium Medicum" - http://con-med.ru/;

3. Journal "Attending Doctor" - http://www.lvrach.ru/;

4. Journal of Neurology and Psychiatry. S. S. Korsakov;

6. Electronic journal "Angiology" - http://www.angiologia.ru/;

8. Journal "Phlebology";

9. Reference book of medicines Vidal - http://www.vidal.ru/;

Do I need to know the ICD arthritis code for a simple patient? On the one hand, let the doctors teach the codes, prescribe medicines and give them sick leave. And on the other hand, you look at the card, and it is written there incomprehensibly, but in bad handwriting, that if you take apart the M25 or something similar, then you will read everything else in the reference book. Without code and not disassemble.

The main thing in this matter is not the codes, but the fact that approaches to treatment depend on the type of arthritis. Rheumatoid - will affect the immune system, and if reactive - then the infection that caused the disease. If the knees hurt after an injury, then they can only relieve the pain.

As a patient, I have been using ICD codification for a long time. According to this document, you can check any appointment. True, you must have a reliable source, otherwise there is so much empty on the Internet that you can choke.

M06.9 Rheumatoid arthritis, unspecified

Rheumatoid arthritis is a chronic disease in which the synovial membrane becomes inflamed, causing joints to become stiff and swollen. Gradually, inflammation destroys the ends of the bone and the cartilage that covers the articular surfaces. The structure and functions of the ligaments that give the joint strength are disrupted, and it begins to deform.

Most often, the disease affects several joints and usually begins on one of the small ones - the hand or foot. As a rule, the disease develops symmetrically. The eyes, lungs, heart, and blood vessels may be involved in the inflammatory process. The disease usually develops slowly, but clinically manifests itself abruptly.

Rheumatoid arthritis is an autoimmune disease, i.e. the synovial membrane, and in some cases other parts of the body, are damaged by their own antibodies.

Women over 60 years of age are more likely to get sick, men - 3 times less often. The disease may be hereditary. Lifestyle doesn't matter.

The general symptoms are partly due to anemia, which occurs because there is a decrease in the amount of bone marrow that produces blood cells.

• joints lose mobility, hurt and swell;
• on areas experiencing pressure (for example, on the elbows), characteristic nodules appear.

Since the disease simultaneously brings pain and deprives of mobility, patients often become depressed. In women with rheumatoid arthritis, the condition may improve during pregnancy, but after the birth of the child, the attacks resume.

With the course of the disease, due to low mobility, the density of the bones connecting in the joint decreases, they become brittle and break easily. In severe cases, osteoporosis of the entire skeleton develops.

In addition, bursitis may develop, i.e. inflammation of the articular bag. Swollen tissues in the wrist compress the median nerve, causing numbness, tingling, and pain in the fingers. If the walls of the arteries that supply blood to the fingers become inflamed, Raynaud's syndrome develops, in which, especially in the cold, the fingers begin to hurt and turn white. Rarely, the spleen and lymph nodes are enlarged. The heart bag - the pericardium - can become inflamed. In some cases, the whites of the eyes become inflamed.

For rheumatoid arthritis, it is characteristic that attacks lasting from several weeks to several months are replaced by relatively asymptomatic periods. A similar, but with characteristic features, form of arthritis is observed in children (see).

It is usually based on the anamnesis and the results of a general examination of the patient. Blood tests are done to confirm the presence of antibodies (called rheumatoid factor) and determine the severity of the inflammation. The destruction of bones and cartilage is assessed by x-rays of the affected joints.

Rheumatoid arthritis is incurable. The task of the doctor is to take the symptoms of the disease under control and prevent the disease from progressing so that the joints do not collapse further. There are many drugs, the choice of which depends on the severity and stage of development of the disease, the age of the patient and his general state of health.

If there are only mild symptoms, non-steroidal anti-inflammatory drugs will be prescribed. However, at the beginning of the disease, the doctor may prescribe stronger drugs that change its course. They should limit the permanent destruction of the joints, but they will have to be taken for several months before improvement occurs. First, sulfasalazine or chloroquine is prescribed. If symptoms persist, gold compounds, penicillamine, methotrexate, or cyclosporine are prescribed. New drugs that target tumor necrosis factor may also be used. Since all these drugs are characterized by severe side effects, the patient should be under constant supervision.

With anemia, which often accompanies rheumatoid arthritis, the hormone erythropoietin is prescribed to improve the condition, which increases the formation of red blood cells.

Splints or corsets will most likely be recommended to reduce stress on a particularly painful joint and prevent deformity. To strengthen the muscles and not lose the mobility of the joints, gentle, but regular exercise is suitable. For this, physiotherapy and / or occupational therapy is carried out. To relieve pain, hydrotherapy is prescribed, as well as hot or cold heating pads. For very severe pain, the doctor may give an intra-articular injection of corticosteroids. If the joint is severely destroyed, surgical implantation is performed, replacing it with a prosthesis.

Most people with rheumatoid arthritis are able to lead normal lives, but lifelong medication is needed to manage symptoms. Approximately 1 in 10 patients develop severe disability due to persistent attacks of the disease. In order to monitor the development of the disease and the response to treatment, you need to regularly donate blood for analysis. Sometimes attacks gradually weaken, and the disease exhausts itself, but in these cases some irreversible changes may remain.

Complete medical reference book / Per. from English. E. Makhiyanova and I. Dreval.- M.: AST, Astrel, 2006.- 1104 p.

ICb code 10 juvenile arthritis

mcb 10 juvenile arthritis

JUVENILE CHRONIC ARTHRITIS is:

JUVENILE CHRONIC ARTHRITIS honey.

Juvenile chronic arthritis (JCA) is a syndromic concept that includes several diseases with different etiologies.

Juvenile idiopathic arthritis - description, causes, symptoms (signs), diagnosis, treatment.

Juvenile idiopathic arthritis(JIA, juvenile rheumatoid arthritis, juvenile chronic arthritis) is a heterogeneous group of diseases united by a tendency to a chronic progressive course. The term was proposed by the WHO Standing Committee on Pediatric Rheumatology (1994) to replace the previously used terms juvenile chronic and juvenile rheumatoid arthritis.

Statistical data. Incidence: 2–19 per 10,000 child population per year. Boys and girls get sick equally often. Etiology unknown. Pathogenesis- see Rheumatoid arthritis.

Genetic aspects. A high prevalence of HLA - DRB1 * 0801 and * 1401 in patients with polyarthritis, HLA - DRB1 * 0101 and 0801 in patients with oligoarthritis was established. The connection of HLA-B27 Ag with the development of arthritis with enthesopathy, as well as HLA-DRB1*0401 with RF-positive polyarthritis, has also been proven.

System option- arthritis with / or previous fever for at least 2 weeks in combination with two or more signs: a fleeting, non-fixed erythematous rash; generalized enlargement of the lymph nodes; hepato- or splenomegaly; serositis. Description Age of disease onset Characteristics of arthritis during the first 6 months of the disease oligoarthritis polyarthritis presence of arthritis only after 6 months of systemic disease Characteristics of arthritis after 6 months of disease oligoarthritis polyarthritis no arthritis after 6 months of systemic disease Features of systemic disease after 6 months Presence of RF CRP level.

Juvenile rheumatoid arthritis

Depending on the type of classification, the disease has the following names: juvenile arthritis (ICD-10), juvenile idiopathic arthritis (ILAR), juvenile chronic arthritis (EULAR), juvenile rheumatoid arthritis (ACR).

Juvenile rheumatoid arthritis (JRA) is an arthritis of unknown cause, lasting more than 6 weeks, which develops in children under the age of 16 years with the exclusion of other joint pathology.

M08. Juvenile arthritis.

M08.0. Juvenile (juvenile) rheumatoid arthritis (seropositive or seronegative). M08.1. Juvenile (juvenile) ankylosing spondylitis. M08.2. Juvenile (juvenile) arthritis with systemic onset. M08.3. Juvenile (juvenile) polyarthritis (seronegative). M08.4. Pauciarticular juvenile (juvenile) arthritis. M08.8. Other juvenile arthritis. M08.9. Juvenile arthritis, unspecified.

JRA is one of the most frequent and most disabling rheumatic diseases that occurs in children. The incidence of JRA is from 2 to 16 people per 100,000 children under the age of 16 years. The prevalence of JRA in different countries is from 0.05 to 0.6%. The prevalence of JRA in children under 18 in the Russian Federation is 62.3 per 100,000, the primary incidence is 16.2 per 100,000. In adolescents, the prevalence of JRA is 116.4 per 100,000 (in children under 14 years - 45.8 per 100,000), primary incidence - 28.3 per 100,000 (in children under 14 years old - 12.6 per 100,000). Girls are more likely to get rheumatoid arthritis. Mortality is 0.5-1%.

Due to the fact that the etiology of JRA is unknown, primary prevention is not carried out.

472 JUVENILE RHEUMATOID ARTHRITIS

Three classifications of the disease are used: the JRA classification of the American College of Rheumatology (ACR), the European League Against Rheumatism (EULAR) classification of juvenile chronic arthritis, the International League of Rheumatological Associations (ILAR) classification of juvenile idiopathic arthritis, which are presented in Table 21-1). Comparative characteristics of all classification criteria are presented in Table. 21-2.

What is juvenile rheumatoid arthritis

Juvenile rheumatoid arthritis was first described at the end of the last century by pediatricians Still and Shaffard, and was originally called Still-Shaffard disease. Juvenile rheumatoid arthritis is a chronic disease that develops only at an early age (before 16 years). The causes of the disease have not yet been elucidated. It manifests itself with a wide range of symptoms, often with involvement of internal organs in the process, progresses rapidly and often leads to disability of the patient. Can influence the processes of growth and development. One of the most common rheumatic diseases in children (in different regions, the incidence ranges from 2 to 16 people per 100,000), girls are more likely to get sick.

According to ICD 10 (International Classification of Diseases), a group of rheumatic diseases that are characteristic only of childhood is called juvenile arthritis, but names such as juvenile idiopathic arthritis or juvenile chronic arthritis may also occur in the literature. In some patients, this form of arthritis may be accompanied not only by joint damage, but also by inflammatory processes in other organs. Professor Alekseeva, who studied this ailment, in her scientific work described the possible causes of the onset and development of the disease.

Manifestations of the disease

There are three types of manifestation of the disease:

1. Systemic lesion (Still's disease): fever, rash, lesions of internal organs (myocardium, liver, kidneys).

2. Oligoarthritis (lesion of no more than 4 joints).

3. Polyarthritis (damage to 5 or more joints, sometimes up to 20).

Arthritis can present in an acute or subacute form. With an acute onset of the disease, the patient develops multiple inflammations of the joints, which are accompanied by edema, swelling, deformities and severe pain. An increase in body temperature is characteristic, more often in the morning. The drop in temperature is accompanied by profuse sweating.

Limb deformity in sick children

Juvenile rheumatoid arthritis

• M08. Juvenile arthritis.
• M08.0. Juvenile (juvenile) rheumatoid arthritis (seropositive or seronegative).
• M08.1. Juvenile (juvenile) ankydotic spondylitis.
• M08.2. Juvenile (juvenile) arthritis with systemic onset.
• M08.3. Juvenile (juvenile) polyarthritis (seronegative).
• M08.4. Pauciarticular juvenile (juvenile) arthritis.
• M08.8. Other juvenile arthritis.
• M08.9. Juvenile arthritis, unspecified.

Epidemiology of juvenile chronic arthritis

Juvenile rheumatoid arthritis is one of the most common and most disabling rheumatic diseases that occurs in children. The incidence of juvenile rheumatoid arthritis ranges from 2 to 16 per 100,000 children under 16 years of age. The prevalence of juvenile rheumatoid arthritis in different countries is from 0.05 to 0.6%. Girls are more likely to get rheumatoid arthritis. Mortality is 0.5-1%.

In adolescents, there is a very unfavorable situation for rheumatoid arthritis, its prevalence is 116.4 per 100,000 (in children under 14 years old - 45.8 per 100,000), the primary incidence is 28.3 per 100,000 (in children under 14 years old - 12.6 per 100,000).

Causes of juvenile chronic arthritis

For the first time, juvenile rheumatoid arthritis was described at the end of the last century by two famous pediatricians: the Englishman Still and the Frenchman Shaffard. Over the following decades, this disease was referred to in the literature as Still-Chaffard disease.

The symptom complex of the disease included: symmetrical damage to the joints, the formation of deformities, contractures and ankylosis in them; development of anemia, enlarged lymph nodes, liver and spleen, sometimes the presence of febrile fever and pericarditis. Subsequently, in the 30-40s of the last century, numerous observations and descriptions of Still's syndrome revealed much in common between rheumatoid arthritis in adults and children, both in clinical manifestations and in the nature of the course of the disease. However, rheumatoid arthritis in children was still different from the disease of the same name in adults. In this regard, in 1946, two American researchers Koss and Boots proposed the term juvenile (juvenile) rheumatoid arthritis. Nosological separation of juvenile rheumatoid arthritis and adult rheumatoid arthritis was subsequently confirmed by immunogenetic studies.

Classification of juvenile chronic arthritis

Three disease classifications are used: American College of Rheumatology (ACR) juvenile chronic arthritis classification, European League Against Rheumatism (EULAR) juvenile chronic arthritis classification, International League of Rheumatological Associations (ILAR) juvenile idiopathic arthritis classification.

Diagnosis of juvenile chronic arthritis

In the systemic variant of juvenile rheumatoid arthritis, leukocytosis (up to 30-50 thousand leukocytes) is often detected with a neutrophilic shift to the left (up to 25-30% of stab leukocytes, sometimes up to myelocytes), an increase in ESR up to 50-80 mm / h, hypochromic anemia, thrombocytosis , an increase in the concentration of C-reactive protein, IgM and IgG in the blood serum.

Treatment goals for juvenile chronic arthritis

• Suppression of the inflammatory and immunological activity of the process.
• Relief of systemic manifestations and articular syndrome.
• Preservation of the functional ability of the joints.
• Prevention or slowdown of joint destruction, disability of patients.
• Achieving remission.
• Improving the quality of life of patients.
• Minimize the side effects of therapy.

With a systemic variant of juvenile rheumatoid arthritis in 40-50% of children, the prognosis is favorable, remission may occur lasting from several months to several years. However, an exacerbation of the disease can develop years after a stable remission. In 1/3 of patients there is a continuously relapsing course of the disease. The most unfavorable prognosis in children with persistent fever, thrombocytosis, long-term corticosteroid therapy. 50% of patients develop severe destructive arthritis, 20% develop amyloidosis in adulthood, and 65% develop severe functional impairment.

All children with early onset polyarticular seronegative juvenile arthritis have a poor prognosis. Adolescents with seropositive polyarthritis have a high risk of developing severe destructive arthritis, disability due to the state of the musculoskeletal system.

In 40% of patients with early-onset oligoarthritis, destructive symmetrical polyarthritis develops. In patients with a late onset, the disease can transform into ankylosing spondylitis. 15% of patients with uveitis may develop blindness.

An increase in the level of C-reactive protein, IgA, IgM, IgG is a reliable sign of an unfavorable prognosis for the development of joint destruction and secondary amyloidosis.

Mortality in juvenile arthritis is low. Most deaths are associated with the development of amyloidosis or infectious complications in patients with a systemic variant of juvenile rheumatoid arthritis, often resulting from long-term glucocorticoid therapy. In secondary amyloidosis, the prognosis is determined by the possibility and success of treating the underlying disease.

Elena Malysheva: A breakthrough in medicine! It is possible to restore the joints completely in 1 course.

Hello, my dear!

For many years now I have been appearing on your TV screens every day, and more than once we have talked about joint problems. Joint disease is very common in the world. Much has been said about methods joint treatment. Basically, it is a medical or surgical intervention in the body. We, in our program, talk about surgery and medical procedures, but very rarely touch on other methods of treatment. And not just recipes from grandmothers, but what was recognized in the scientific community, and, of course, recognized by our viewers. Today we will talk about the healing effect of native osteoblastic and chondrocyte cells of the Altai deer antlers, enriched with the milky juice of medicinal plants. They and many other substances are part of the newest product - "Artropant".

So, let's start with how all these substances that make up "Artropant". can help in such a serious disease? If you remember, a few issues ago, I talked about how to heal joint pain and more. To do this, you need to start the process of return, that is, to return the cells of the body to their original state. After all, medicine, most of all, is struggling with the consequences. And it is necessary to eliminate the cause and return the body to its original state. That is why, after taking the correct dosage of certain substances contained in this unique remedy, most patients feel light, as if they were born again. Men, in turn, felt a surge of strength and energy. The pain disappears.

"Artropant" helps to cope even with such terrible diseases as arthritis, arthrosis and osteochondrosis. "Artropant" well relieves inflammation and pain during exacerbations of diseases of the joints, cartilage and ligaments. As studies have shown, there can be several reasons for joint damage: these are circulatory disorders, malnutrition, a sedentary lifestyle, immune disorders, hormonal changes, and improper cell function. That is, the whole system directly affects the state of the body. And this connection helps to fight the disease as effectively as possible.

And how does it work, you ask? Will explain. “Artropant” is a natural organic cream of intense penetrating action based on native osteoblastic and chondrocyte cells of the Altai maral antlers, enriched with the milky juice of medicinal plants that have anti-inflammatory, analgesic, wound healing, regenerating, restorative, anti-infective effects. As a result, the body begins the healing process, namely, it returns, as we say, to the point of health.

At the moment, there is only one official site that sells the original product, and not a cheap fake. There is a lot of talk about him on our channel. And not in vain! This is not just a cream, but a unique blend of the rarest and most powerful natural healing substances. This tool has proven its effectiveness not only to patients, but also to science, which has recognized it as an effective drug. Joint and back pain go away in 10 days, studies have shown. The main thing is to strictly follow the instructions in the methodology!

We invited Igor Krylov to the studio, one of the thousands of patients who were helped Artropant :

Igor Krylov: Every day I felt an improvement. Pain in the joints receded by leaps and bounds! In addition, there was a general recovery: tissues were actively healing and metabolic processes were activated, I could afford to eat almost anything I wanted and even run. I realized that this is the only way out for me! The pain is gone forever. At the end of the course, I became an absolutely healthy person! The main thing is a complex effect. Classical treatment does NOT remove the ORIGINAL CAUSE of the disease, but only fights its external manifestations. Artropant RESTORES cartilage tissue with the help of Altai deer antler cells, while our doctors are always falling asleep with complex, incomprehensible terms and trying to sell expensive drugs that are of no use ... I tried all this on myself personally

Elena Malysheva: Igor, tell us in more detail how to use this miracle remedy!

Igor Krylov: Everything is very simple! You need to take a small amount of funds, apply to problem areas and massage with massage movements until the cream is absorbed. I order only on the official website. To receive it, fill in your details on the site, leave a working phone number so that they can contact you and discuss the details. I received this remedy in 4 days, it came in a sealed package, without identification marks. The tool is worth a penny, relative to the price that I spent on the treatment! There are instructions so it's easy to understand. Already after the first dose, improvement is felt. Try it yourself and you will understand me.

Elena Malysheva: Thank you Igor, our operators will place a link to the site to place an order.

As you can see, the path to health is not so difficult. "Artropant" can order on the official website.

Original "Artropant" can only be ordered on the official website, which is published below. This product has all the necessary certificates and has been tested for effectiveness. There are a lot of fakes in Russia, ordering which you will not get any effect.

Rheumatoid arthritis classification according to ICD 10

Classification and codes of ICD-10 forms of rheumatoid arthritis and its complications

Etiology and risk factors

The causes of the pathology have not been established today.

• Genetically determined predisposition to this disease. At risk are people over 50 years of age.
• The trigger for the activation of the pathological process are hormonal disorders, overweight. Mostly women get sick. Often they develop a serious autoimmune disease during pregnancy, postmenopause.
• Viral infections can provoke the occurrence of a systemic disease. Bad habits affect the condition of the joints.
• Being in a forced position, prolonged static work.

A combination of various factors leads to the development of systemic inflammation.

Systemic disease pathogenesis

Abnormal functioning of the immune system is the basis for the onset and progression of rheumatoid arthritis, which has the ICD10 code M06. The body has immune cells that are designed to protect the body. These antibodies are produced after the illness. However, instead of attacking bacteria and viruses, blood cells misbehave.

For various reasons, immune complexes mistakenly begin to destroy the body's own cells and joints. Foci of lymphocytic infiltration occur in tissues as abnormal immune cells migrate to the joint area. There is a lesion and swelling of the articular membrane, cartilage tissue of the joints. This leads to destruction of the body. In the absence of proper treatment, over time, a serious deformation of the arms and legs occurs.

Symptoms of rheumatoid arthritis

The classical picture of the disease is typical. There is a systemic inflammatory process.

Rheumatoid arthritis has a progressive course. But sometimes there are remissions - periods of temporary improvement.

1. An early symptom is swelling of the joints, which is characteristic of inflammation of the joint capsule. This is the synovium of the articulation.
2. At least three joints are affected. In patients, the bones of the palms and lower jaw suffer. Elbow and knee joints are less commonly affected.
3. Stiffness in the hands in the morning disrupts daily life. The patient's joints are not functioning. He needs to move to restore their work. This usually takes at least 30 minutes. The symmetry of the lesions of the joints is characteristic.
4. Subfebrile temperature. Very heavy feeling.
5. Damage to internal organs. The pathological process involves the lungs, heart, kidneys. Heart attack, angina pectoris, pleurisy in rheumatoid arthritis occur more often.
6. Each movement begins with a sharp pain, which greatly interferes with life.
7. Redness of the joint.

Types of joint inflammation

There are several types of arthritis:

8. For a long time, the knee aches after heavy exertion or injury - this is a symptom of traumatic arthritis.
9. Joints ached after SARS - a sign of reactive arthritis.
10. The joint breaks, and the patient suffers from psoriasis - most likely, this is psoriatic arthritis.
11. If the joints in a child are sick, this may indicate the development of juvenile arthritis.
1. Immobilization. High susceptibility to disability.
2. The disease provokes the development of osteoporosis. Bone tissue becomes looser, weaker. Breaks are possible.
3. The results of clinical tests allow you to determine the disease.
4. The erythrocyte sedimentation rate is a very important indicator of the presence of inflammation. ESR values ​​above 30 mm / h in women, above 20 mm / h in men indicate the possibility of developing rheumatoid arthritis, which has the M06 code in the ICD10.
5. X-ray data show specific changes in the joints.

Therapy for rheumatoid arthritis should begin immediately, without waiting for complications and irreversible consequences. Today there are international standards for the treatment of this pathology.

Basic principles of recovery:

6. When choosing a treatment course, the specialist takes into account the duration of the disease, the characteristics of pain. In the early stages, active surveillance is established to monitor the patient's health status. The patient should regularly visit a rheumatologist, take the necessary tests. If necessary, once a year, a liver puncture is done in order to check its condition.
7. First, one drug is used. Basic antirheumatic drugs, non-steroidal anti-inflammatory drugs are used. Voltaren, Naproxen, Ibuprofen, Ortofen, Indomethacin can relieve inflammation.
8. If first-line drugs do not help, during the acute phase, the doctor prescribes steroids - hormones. This allows you to keep the inflammatory process at a very low level.
9. To save the patient from constant steroid therapy, immunosuppressants are used as prescribed by the doctor. These drugs modify the disease. They prevent abnormal immune cells from destroying body tissues. Most often, doctors prescribe Methotrexate, since its effectiveness has been fully proven today. Plaquenil is used as an immunosuppressant.
10. After achieving remission, the doctor recommends switching to a maintenance dose of drugs.
11. In severe cases, the patient has to replace the joints, put prostheses.

If you experience pain in the joints, you should consult a specialist. It is impossible to start this serious illness. With improper therapy, this pathology can cause many problems. Only intensive treatment can prevent complications and make life easier for patients.

5. Journal "Scientific and Practical Rheumatology";

7. JOURNAL "ANGIOLOGY AND VASCULAR SURGERY";

10. Directory of RLS drugs - http://www.rlsnet.ru/;

Classification of rheumatoid arthritis ICD 10

This disease is one of the urgent problems in medicine. Rheumatoid arthritis has an ICD-10 code: M05-M14. ICD 10 - International Classification of Diseases of the 10th revision. This disease is characterized by inflammation of the joints, wear of cartilage tissue. Many patients complain of redness of the skin and itching in the affected area. Even doctors sometimes confuse arthrosis and arthritis. In fact, these are completely different types of diseases. Arthrosis is rather an age-related degeneration of the articular cavities. Arthritis is an inflammatory process of the joints. Inaction often leads to disability.

Rheumatoid arthritis is a terrible disease that affects not only the elderly, but also infants. This disease extends to all categories of ages. It's like an epidemic, it spares no one.

Lack of treatment leads to deformation of the area where rheumatoid arthritis is developed. Serious deformity does not pass without a trace, many symptoms begin to disturb the patient. Joints swell and bring hellish discomfort. Cartilage and bone continue to break down, threatening the patient with disability.

Patients with rheumatoid arthritis with the code ICD 10

Why is it necessary to write the coding on the patient card:

12. Taking the card, the doctor knows the patient's complaints, what worries him the most.

Rheumatoid arthritis according to the 10th international classification is a disease of the musculoskeletal system, which has many varieties. The international classification distinguishes the following codes for rheumatoid arthritis: M06.0, M06.1, M06.2, M06.3, M06.4, M06.8, M06.9. These are the main points into which the disease is divided. In fact, each type has several sub-items. In the ICD 10 system, rheumatoid arthritis has a code from M05 to M99.

If the disease is not treated, complications may occur:

13. disability;
14. development of osteoporosis;
15. fractures and other injuries;
16. immobilization.

Symptomatic manifestations of the disease

17. the joints cease to function properly, morning stiffness is observed, which significantly worsens the patient's well-being;
18. the temperature in the affected area rises, the swelling is hot to the touch and the state of health worsens;
19. increased risk of getting a heart attack;
20. sharp pain;
21. swelling and redness of the articular surfaces.

The main symptom is the presence of an inflammatory process. Rheumatoid arthritis is a progressive disease with periods of temporary improvement.

Post navigation

Arthritis code micb 10: knee joint, treatment

This facilitates and improves the process of treating the patient. So, if the patient has an arthritis code of microbial 10 on the card, then all medical staff, all employees of the institution will be able to provide adequate assistance, provide advice that meets the standards, and conduct all the necessary laboratory tests and diagnostics in this case. .

There is no misunderstanding between the patient and the medical staff, since this designation already gives an understanding of the reasons for a person to go to the hospital. The patient will not be able to correctly, from a medical point of view, explain why he is sick. And the entry in his medical records - rheumatoid arthritis mkb 10, will give an understanding of what health workers faced in this case.

Patients with arthritis code mkb 10

List of diseases of the musculoskeletal system

The list of diseases of the musculoskeletal system and inside the connective tissues according to ICD 10 revision looks something like this:

22. M00 Pyogenic arthritis
23. M03 Post-infectious and reactive arthropathy

This list can be continued up to M99. In turn, each item is divided into sub-items.

24. M06.0 Seronegative rheumatoid arthritis
25. M06.1 Adult Still's disease
26. M06.3 Rheumatoid nodules
27. M06.8 Dr. specified rheumatoid arthritis

Sometimes, patients with the same diagnosis, for example, arthritis of the knee joint, are divided into different groups according to ICD 10 revision.

Even with similar main symptoms of the disease:

28. pain symptom
29. restriction of mobility
30. swelling and redness associated with inflammation

Indeed, according to the classification, such patients are distributed according to individual indicators, according to the nature of the course and signs of the disease.

Such arthritis may be in the group of reactive arthritis according to microbial 10, if there are additional symptoms in the signs that are characteristic of this particular type of disease:

31. general metabolic disorders
32. renal dysfunction
33. failures in the system of water-salt balance
34. polyarthritis

Gouty arthritis according to ICD 10 and its symptoms

The main thing is to contact medical institutions in a timely manner, undergo all the prescribed examinations, take all the recommended tests and take the prescribed medications strictly according to the scheme prescribed by the attending physician.

Illness is always a big problem for a person. When an ailment is detected, the patient is not so much interested in the subgroup and font of the disease in the international classification of diseases as a positive outcome.

Medicine is developing rapidly. Such a classification is an example of the fact that doctors keep up with the times, improve their methods, and improve their approach to patient care.

Rheumatoid arthritis ICD code 10: juvenile, seropositive, seronegative.

Clinical picture of a schematic representation of a joint damaged by rheumatoid arthritis.

The disease begins with persistent arthritis, affecting mainly the joints of the feet and hands.

Subsequently, all joints of the limbs without exception can be involved in the inflammatory process.

Arthritis is symmetrical, affecting the joints of one articular group on both sides.

Before the onset of symptoms of arthritis, the patient may be disturbed by muscle pain, slight flying pains in the joints, inflammation of the ligaments and articular bags, weight loss, and general weakness.

In the initial stage of arthritis, the clinic of joint damage can be unstable, with the development of spontaneous remission and the complete disappearance of the articular syndrome.

However, after some time, the inflammatory process resumes, affecting more joints and with increased pain.

The mechanism of development of rheumatoid arthritis

Despite the fact that the etiology of rheumatoid joint damage is not clear, the pathogenesis (development mechanism) has been sufficiently studied.

The pathogenesis of the development of rheumatoid arthritis is complex and multi-stage, it is based on the launch of a pathological immune response to the impact of an etiological factor.

Inflammation begins with the synovial membrane of the joint - it is the inner layer of the joint capsule.

The cells that make up it are called synoviocytes or synovial cells. Normally, these cells are responsible for the production of joint fluid, the synthesis of proteoglycans, and the removal of metabolic products.

During inflammation, the synovial membrane is infiltrated by cells of the immune system, with the formation of an ectopic focus in the form of an overgrowth of the synovial membrane, such an overgrowth of synoviocytes is called pannus.

Constantly growing in size, the pannus begins to produce inflammatory mediators and antibodies (altered IgG) against synovial components that destroy the surrounding cartilage and bone tissue. This is the pathogenesis of the beginning of the formation of articular erosions.

At the same time, the growth of cells that produce antibodies to synovial structures is stimulated by various colony-stimulating factors, cytokines, and metabolic products of arachidonic acid.

The pathogenesis of the development of rheumatoid inflammation of the joints at this stage is included in a kind of vicious circle: the more cells that produce aggression factors, the more inflammation, and the more inflammation, the more stimulated the growth of these cells.

The altered IgG produced by the synovial membrane is recognized by the body as a foreign agent, which triggers autoimmune processes and the production of antibodies against this type of immunoglobulin begins.

This type of antibody is called rheumatoid factor, and their presence greatly simplifies the diagnosis of rheumatoid arthritis.

Rheumatoid factor, getting into the blood, interacts with altered IgG, forming immune complexes circulating in the blood. The formed immune complexes (CIC) settle on the articular tissues and vascular endothelium, causing their damage.

CEC, settled in the walls of blood vessels, are captured by macrophages, which leads to the formation of vasculitis and systemic inflammation.

Thus, the pathogenesis of systemic rheumatoid arthritis is the formation of immunocomplex vasculitis.

Cytokines, in particular tumor necrosis factor, also have a great influence on the pathogenesis of the disease.

It triggers a number of immunological reactions, leading to stimulation of the production of inflammatory mediators, joint damage and chronicity of the process.

Rheumatoid arthritis ICD 10

For the classification of rheumatoid arthritis in modern medical practice, ICD 10 and the classification of the Russian Rheumatological Association of 2001 are used.

The ICD classification of rheumatoid arthritis refers it to diseases of the musculoskeletal system and connective tissue (code M05, M06).

The classification of the Rheumatological Association is more extensive.

It not only divides rheumatoid arthritis according to clinical manifestations, but also takes into account the results of serological diagnostics, the radiological picture and the violation of the patient's functional activity.

Rheumatoid arthritis code according to ICD 10:

1. M05 - seropositive rheumatoid arthritis (rheumatoid factor is present in the blood):

• Felty's syndrome - M05.0;
• Rheumatoid vasculitis - M05.2;
• Rheumatoid arthritis spreading to other organs and systems (M05.3);
• RA seropositive unspecified M09.9.

1. M06.0 - seronegative RA (no rheumatoid factor):

• Still's disease - M06.1;
• Rheumatoid bursitis - M06.2;
• Unrefined RA M06.9.

1. M08.0 - juvenile or childhood RA (in children from 1 to 15 years old):

• ankylosing spondylitis in children - M08.1;
• RA with systemic onset - M08.2;
• Juvenile seronegative polyarthritis - M08.3.

Inflammatory activity, reflected in this classification, is assessed by a combination of the following symptoms:

• the intensity of the pain syndrome on the VAS scale (Scale from 0 to 10, where 0 is the minimum pain, and 10 is the maximum possible pain. The assessment is subjective). Up to 3 points - activity I, 3-6 points - II, more than 6 points - III;
• stiffness in the morning. Up to 60 minutes - activity I, up to 12 hours - II, all day - III;
• ESR level. 16-30 - activity I, 31-45 - II, more than 45 - III;
• C-reactive protein. Less than 2 norms - I, less than 3 norms - II, more than 3 norms - III.

If the above symptoms are absent, then stage 0 of activity is set, that is, the stage of remission.

Course and forecast

Rheumatoid arthritis is a chronic, steadily progressive disease with periods of exacerbations.

Exacerbation of rheumatoid arthritis can provoke viral infections, hypothermia, stress, trauma.

The prognosis of rheumatoid arthritis depends, first of all, on the stage at which the disease was detected, and on the literacy of the selected treatment.

The earlier basic drug therapy begins, the better the prognosis of the disease regarding the preservation of working capacity and the ability to self-service.

The most frequent complications of rheumatoid arthritis are the development of joint dislocations, their deformity and the occurrence of ankylosis, which causes such consequences as limitation of the patient's normal daily activities and inability to move.

A condition such as ankylosis is the worst thing that rheumatoid arthritis is dangerous for, it leads to complete immobility of the joint and loss of self-care.

The gait is disturbed, over time it becomes more and more difficult to move. Ultimately, progressive rheumatoid arthritis leads to disability.

The prognosis for life is favorable, the average life expectancy in patients with confirmed rheumatoid arthritis is only 5 years less than in people from the general population.

With complex treatment, regular exercise therapy, 20-30% of patients manage to maintain activity, despite the progressive disease.

Rheumatism according to ICD 10 is an autoimmune disease associated with the appearance of circulating immune complexes after contact of the body with group A hemolytic streptococcus. It develops with the congenital similarity of the antigenic structure of the connective tissue and streptococcus, affects the valvular apparatus of the heart, large joints and the central nervous system. It is divided into forms of the disease with the formation of heart defects and without them.

This pathology can occur after suffering a sore throat. In modern times, rheumatism is much less common, the massive use of antibiotics does not allow the development of autoimmune processes.

The incidence of the disease in developed countries among the adult population is up to 0.9%, and in childhood - at least 0.6%. With the development of rheumatism from a young age to adulthood (30-40), about 80-90% do not survive.

Rheumatism according to the registry microbial 10 is a systemic autoimmune disease. Its classification is based on damage to the joints, heart valves, central nervous system, stages and severity of the disease.

For a complete list of this pathology, the international classification of diseases of the 10th revision is used. According to ICD - 10, each disease has its own encoding. The rheumatism code begins with the Latin letter I, which refers to all diseases of the circulatory system. The code for rheumatism and rheumatic fever is 00-09.

Acute rheumatic fever (ARF - ICb 10 rheumatic fever code I00-I02).

I 00 Rheumatic fever without effect on heart disease.

I 01 Rheumatic fever with influence on the appearance of heart disease.

I01.0 pericarditis;

I01.1 endocarditis;

I01.2 myocarditis;

I01.8 Other acute rheumatic heart diseases.

I 02 Chorea.

Chronic rheumatic heart disease (code I05-I09):

I 05 Rheumatic diseases of the mitral valve.

I05.0 mitral stenosis;

I05.1 mitral insufficiency;

I05.2 Mitral stenosis with mitral insufficiency.

I 06 Rheumatic diseases of the aortic valves.

I 07 Rheumatic diseases of the tricuspid valve.

I 08 Multiple valvular lesions.

I 09 Other rheumatic affections of the heart.

I09.0 Rheumatic myocarditis;

I09.1 chronic endocarditis, valvulitis;

I09.2 Chronic pericarditis

Classification of rheumatism

Clinicians and theorists distinguish two forms of rheumatism - active and inactive. Some separate progressive, fading, and relapsing phases. This pathology may be in the chronic stage with the involvement of the valvular apparatus and myocardium. Palindromic (recurring) rheumatism was described as early as 1891.

In medicine, rheumatism is classified according to two criteria: according to clinical manifestations and the degree of disease activity.

Clinical manifestations of acute rheumatic fever:

Classification of rheumatism according to the degree of activity:

First degree. The minimum degree, which has mild symptoms. Differs in minor symptoms or their absence.

The second degree or the average degree of activity. May be associated with fever and carditis. It is characterized by an increase in ESR, leukocytes and a number of other indicators of a blood test.

Third degree (maximum). It is distinguished by the appearance of fever with fluid effusion in the cavity (polyarthritis, serositis). In the biochemical analysis, the content of proteins - inflammation (CRP, a-globulins, seromucoid) and enzymes is sharply increased.

When diagnosed, damage to the central nervous system, heart, joints and other organs occurs. Often professors characterize the disease with the expression "rheumatism kisses the brain, licks the joints and bites the heart."

Such a disease is quite difficult to treat, but with proper and timely examination, treatment, a complete recovery occurs.

Causes and risk factors

The main cause of such a disease is infection with a group A bacterium, only beta-hemolytic streptococcus contains a rheumatogenic factor that determines the development of rheumatism. The second reason is the similarity of antigens of the microbe and cartilage tissue. Together, these causes can cause the development of auto-aggression of the immune system against the connective tissue of the body.

Risk factors for developing rheumatic disease:

• the presence of a characteristic streptococcus that causes hemolysis (a provoking factor);
• genetic predisposition of the immune status;
• inflammatory factors.

The course and prognosis of the disease

Rheumatism proceeds in 3 stages:

1. Autoimmune (the appearance of immune antigen-antibody compounds and the production of autoantibodies occur in it).
2. Vascular (pathology of the microvasculature and blood coagulation system, leading to the formation of blood clots).
3. Inflammatory (exudative reactions of connective tissue).

The course of ARF and rheumatism:

In 75% of patients, attacks of rheumatism subside no more than 6 weeks, in 95% of patients within 12 weeks there is a complete recovery. And only 5% of the course of the disease can exceed six months. Such patients are characterized by all clinical manifestations in a severe and neglected form. The frequency of exacerbations depends on the degree of re-infection with the bacterium, the presence of lesions of the cardiovascular system, and the duration of the remission stage.

Carditis develops in almost all patients. In the absence of coarse noises over the apex of the heart, a favorable prognosis of rheumatism should be judged.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Rheumatoid arthritis codes in the International Classification of Diseases

The most important thing in the diagnosis and treatment of any disease is to make the correct diagnosis. Understanding the causes and knowing the symptoms helps the doctor assess the situation and make a decision on the tactics of therapy, which is especially important with a wide variety of diseases in humans. The International Classification of Diseases 10th Revision (ICD-10) is not only disease statistics, but also a real assistant to the doctor in daily work. Rheumatoid arthritis is classified under Arthropathy and is a type of disease that affects the peripheral joints. There are a lot of different types of pathological processes associated with inflammation. To easily navigate among this variety, the specialist uses a convenient and detailed classification that takes into account all the nuances of joint diseases.

Arthropathy options

Articular diseases that mainly affect the limbs include the following types of pathology:

• infectious (in ICD-10 they have the code M00-M03);
• inflammatory pathology of the joints (M05-M14);
• arthrosis (M15-M19);
• other joint lesions (M20-M24).

Rheumatoid arthritis is included in the group "Inflammatory arthropathies", which indicates the nature of the disease and helps the doctor to correctly assess the causative factor of articular pathology.

Disease coding

The defeat of the joints by rheumatism manifests itself in a variety of ways, being the cause of diseases of the internal organs and forming complex syndromes. The doctor needs to choose the correct code in the ICD-10 in order to carry out effective treatment, taking into account the possible damage not only to the joints, but also to other organs and systems of the human body. At the stage of preliminary examination, a specialist can use a code that does not accurately indicate a specific disease, but as new diagnostic information is received, the diagnosis is corrected.

Table. ICD-10 code for various variants of rheumatoid joint disease

In the ICD-10, codes M07-M14 encode numerous joint diseases caused by any factors other than rheumatism. Their use involves identifying the exact causes and detecting typical symptoms of pathology.

For any type of joint disease, the doctor can find the appropriate ICD-10 code. It is important to conduct a complete diagnosis and identify the underlying causative factor of the disease in order to accurately determine the code.

Significance of the ICD-10

The classification of diseases used by doctors all over the world makes it possible to accurately account for all cases of severe articular pathology associated with rheumatic disease. Thanks to this, specialists in different countries can learn and adopt the experience of other doctors, better understand the causes of inflammatory arthropathy and use advanced therapies. Rheumatoid arthritis requires a careful approach to examination and treatment, because this problem can become the basis for severe complications and disability of a person.

ICD-10 - generally accepted international classification of diseases

Having determined the diagnosis, the doctor will prescribe treatment. Rheumatoid arthritis should be treated comprehensively, providing a therapeutic effect with drugs, the action of which is aimed at removing pain and improving joint mobility. It is necessary to accurately and consistently follow the recommendations of a specialist in order to get rid of problems in the present and prevent complications in the future. This is especially important in the complicated course of articular disease, when there is damage to internal organs. The main factor of treatment is basic therapy prescribed for a long time. Be sure to use symptomatic treatment. The effectiveness of therapy will be much higher if therapeutic measures are started as early as possible, before external changes in small joints. That is why timely examination and correct diagnosis in accordance with ICD-10 is the best way to prevent complicated forms of the disease.

Don't crunch!

treatment of joints and spine

• Diseases
  • Arothrosis
  • Arthritis
  • Bechterew's disease
  • Bursitis
  • Dysplasia
  • Sciatica
  • Myositis
  • Osteomyelitis
  • Osteoporosis
  • fracture
  • flat feet
  • Gout
  • Radiculitis
  • Rheumatism
  • Heel spur
  • Scoliosis
• joints
  • Knee
  • Brachial
  • Hip
  • Other joints
• Spine
  • Spine
  • Osteochondrosis
  • cervical
  • Thoracic
  • Lumbar
  • Hernias
• Treatment
  • Exercises
  • Operations
  • From the pain
• Other
  • muscles
  • Bundles

Rheumatoid arthritis ICD code 10

ICD 10 coding for rheumatoid arthritis

Arthritis classification according to ICD 10

(according to the presence of RF): seropositive, seronegative

A distinction was made according to the following types of etiological relationship: a) direct infection of the joint, in which microorganisms invade the synovial tissue and microbial antigens are found in the joint; b) indirect infection, which can be of two types: “reactive arthropathy”, when microbial infection of the body is established, but neither microorganisms nor antigens are detected in the joint; and "post-infectious arthropathy", in which the microbial antigen is present, but the recovery of the organism is incomplete and there is no evidence of local reproduction of the microorganism.

Cyclophosphamide (200 mg ampoules), endoxan - 50 mg tablets

Reactive Arthritis Symptoms

Second degree - the pain intensifies, the restriction of motor activity is such that it leads to a decrease in working capacity and limitation of self-service.

1. The symptom complex of the disease included: symmetrical damage to the joints, the formation of deformities, contractures and ankylosis in them; development of anemia, enlarged lymph nodes, liver and spleen, sometimes the presence of febrile fever and pericarditis. In the subsequent years of the last century, numerous observations and descriptions of Still's syndrome revealed much in common between rheumatoid arthritis in adults and children, both in clinical manifestations and in the nature of the course of the disease. However, rheumatoid arthritis in children was still different from the disease of the same name in adults. In this regard, in 1946, the term "juvenile (juvenile) rheumatoid arthritis" was proposed by two American researchers Koss and Boots. Nosological separation of juvenile rheumatoid arthritis and adult rheumatoid arthritis was subsequently confirmed by immunogenetic studies.
2. This type of rheumatoid arthritis includes Still and Wieseler-Fanconi syndrome. Still's syndrome is more commonly diagnosed in preschoolers. It is distinguished by the following features:
3. Juvenile rheumatoid arthritis is a pathology that develops in children and adolescents under 16 years of age, in which not only the joints, but also other organs can be affected. A doctor can make a similar diagnosis if a child has arthritis that lasts more than 6 weeks. The disease does not occur very often. International statistics says that JRA is detected in 0.05-0.6% of children. Children under 2 years of age suffer from this disease extremely rarely. There are gender differences in the incidence among children. Arthritis is diagnosed more often in girls. The disease is steadily progressing.

Stages of development of the disease and the degree of destruction of the joint

NSAIDs Patients at risk of developing gastropathy and gastrointestinal bleeding (age over 75 years, history of gastrointestinal ulcers, simultaneous use of low doses of acetylsalicylic acid and HA, smoking) can be prescribed selective or specific COX-2 inhibitors, either (subject to high individual effectiveness) non-selective COX inhibitors in combination with misoprostol 200 mcg 2-3 times / day or proton pump inhibitors (omeprazole 20-40 mg / day) In patients with impaired renal function, NSAIDs should be treated with extreme caution If there is a risk of thrombosis, patients receiving selective COX-2 inhibitors should continue to take small doses of acetylsalicylic acid at the same time.

Diagnosis and treatment of the disease

Alkylating cytostatic; forms alkyl radicals with DNA, RNA and proteins, disrupting their function; has an antiproliferative effect.

Pronounced edema from the very beginning of the disease

In the third degree - the impossibility of self-service, a significant loss of mobility in the joint (joints).

What causes juvenile rheumatoid arthritis?

Learning to live with a diagnosis according to ICD 10 - rheumatoid arthritis

Causes and symptoms of rheumatoid arthritis

​If treatment is not started early, there is a high risk that the child will become disabled.​

The World Health Organization (WHO) has developed a special medical coding for the diagnosis and definition of medical diseases. ICD 10 code - coding for the international classification of diseases of the 10th revision as of January 2007.​

​GK Systemic application. It is recommended to use low< 10 мг/сут) дозы ГК, что позволяет адекватно « контролировать» ревматоидное воспаление, но должно обязательно сочетаться с базисной терапией Локальная терапия ГК имеет вспомогательное значение. Предназначена для купирования активного синовита в 1 или нескольких суставах. Повторные инъекции ГК в один и тот же сустав необходимо производить не чаще 1 раза в 3 мес. Противопоказания к проведению локальной терапии: гнойный​​быстропрогрессирующий, медленнопрогрессирующий (оценка темпа развития деструктивных изменений в суставе при длительном наблюдении) ​

Staphylococcal arthritis and polyarthritis

How to treat rheumatoid arthritis?

RA with systemic manifestations (vasculitis, nephropathy).

Edema appears when inflammation is attached

According to the nature of occurrence in medicine, several forms of arthritis are distinguished:

The pathogenesis of juvenile rheumatoid arthritis has been intensively studied in recent years. The development of the disease is based on the activation of both cellular and humoral immunity.

The primary incidence rate is from 6 to 19 cases per 100,000 children. It is important that the prognosis for health largely depends on the age at which the disease began. The older the child, the worse the prognosis. Still's disease is a type of rheumatoid arthritis. The disease is very severe, with severe fever, joint syndrome, damage to the lymphatic system and sore throat. This pathology also occurs in adults.

There are currently 21 disease classes, each containing subclasses with disease and condition codes. Rheumatoid arthritis ICD 10 belongs to the XIII class "Diseases of the musculoskeletal system and connective tissue." Subclass M 05-M 14 "Inflammatory processes of polyarthropathy."​

Rheumatoid arthritis: we treat folk methods

200 mg IM 2-3 times a week until a total dose of 6-8 g per course is reached; combined pulse therapy; endoxan at dosemg / day, maintenance dose - 50 mg / day. Methods of operative surgery (injections into the articular cavity).

Etiology and treatment of juvenile rheumatoid arthritis

Features of the disease

reactive - a complication that occurs with untreated (undertreated) infections; Pathogenesis of juvenile chronic arthritis

polyarthritis involving small joints in the process;

Etiological factors

Juvenile arthritis can occur for a variety of reasons. The exact reason has not yet been established.​

Reactive arthritis of the knee is the most common rheumatic disease. The disease is characterized by a non-purulent inflammatory formation in the bone structure. In some cases, the disease occurs as a response to infectious diseases of the gastrointestinal tract (GIT), urinary tract and organs of the reproductive system.

• , unspecified nature
• I - low, II - moderate, III - high activity
• Pneumococcal arthritis and polyarthritis
• Hemorrhagic cystitis, myelosuppression, activation of foci of infection.
• Of the medications, NSAIDs, cytostatics, hormonal agents, antibiotics, etc. are prescribed. The set of medications directly depends on the type and etiology of arthritis. Table 2 lists the treatment regimens for rheumatoid arthritis.​
• Yes, but it may not be right away
• Rheumatoid - is a consequence of rheumatic diseases;

The main clinical manifestation of the disease is arthritis. Pathological changes in the joint are characterized by pain, swelling, deformities and limitation of movement, increased skin temperature over the joints. In children, large and medium joints are most often affected, in particular, knee, ankle, wrist, elbow, hip, less often small joints of the hand. Typical for juvenile rheumatoid arthritis is the defeat of the cervical spine and maxillotemporal joints, which leads to underdevelopment of the lower, and in some cases, the upper jaw and the formation of the so-called "bird's jaw".

Forms of the disease

Enlargement and soreness of the lymph nodes;

Possible etiological factors are:

• The development of arthritis occurs a month after infection, however, the provocative infection that caused this disease does not manifest itself in the human body. Men over the age of 45 are most at risk. Sexually transmitted infections (gonorrhea, chlamydia, and others) can contribute to the progression of the disease. Women are less likely to suffer from this disease.
• arthritis
• Radiological stage:

Clinical symptoms

Chlorbutin (leukeran) - tablets of 2 and 5 mg

• drug
• Yes, but in the later stages of redness may not be
• Acute - develops after bruises, fractures, strong physical exertion;
• Symptoms of juvenile chronic arthritis
• hepatosplenomegaly;

the presence of a viral or bacterial infection;

If the carrier of the infection entered the body with food, reactive arthritis can equally develop in both men and women.

• , any changes in the skin near the puncture site, tuberculosis of the joint, tabes of the spinal cord, aseptic bone necrosis, intra-articular fracture, subluxation of the joint. The following drugs are used (a full dose of drugs is injected into large joints, 50% into medium-sized joints, 25% into small ones): Methylprednisolone 40 mg Hydrocortisone 125 mg Betamethasone in the form of injections (celeston, flosteron, diprospan) Pulse therapy methylprednisolone leads to a rapid but short-term effect (3-12 weeks); not affecting the rate of progression of the process In order to prevent osteoporosis, people receiving GCs are prescribed calcium (1500 mg / day) and cholecalciferol (400-800 IU / day), and in the absence of their effectiveness - bisphosphonates and calcitonin (see Osteoporosis). ​
• I - periarticular osteoporosis, II - the same + narrowing of the interarticular spaces + single erosions, III - the same + multiple erosions, IV - the same + ankylosis H
• Other streptococcal arthritis and polyarthritis
• Alkylating cytostatic; forms alkyl radicals with DNA, RNA and proteins, disrupting their function; has an antiproliferative effect
• ​Operating principle​

Other manifestations

infectious - caused by viruses or a fungal infection that enters the joint with the blood stream, or through an unsterile surgical instrument, often leads to the development of purulent inflammation of the knee joint;

• In the systemic variant of juvenile rheumatoid arthritis, leukocytosis (up to a thousand leukocytes) is often detected with a neutrophilic shift to the left (up to 25-30% of stab leukocytes, sometimes up to myelocytes), an increase in ESR domm / h, hypochromic anemia, thrombocytosis, an increase in the concentration of C-reactive protein , IgM and IgG in blood serum.
• anemia;
• traumatic joint injury;
• A characteristic feature of the course of the disease is the symmetry of joint damage
• ​Basic Therapy​
• Availability of functional ability:

• High RA activity with systemic manifestations, generalized lymphadenopathy, splenomegaly.
• ​Operating principle​
• Observed in the case of an autoimmune nature of the disease
• Reiter's syndrome is a type of reactive arthritis;
• Diagnosis of juvenile chronic arthritis
• myocardial damage;
• increased insolation;
• Reactive arthritis is severe. In the first week, the patient has a fever, disorders of the gastrointestinal tract (GIT), acute intestinal malaise, general weakness. In the future, the symptoms of arthritis progresses and is of a classic nature. At this stage of development, the disease can be divided into 3 types.
• ​Basic therapy should be given to all patients with reliable RA.​

​0 - retained, I - professional ability retained, II - professional ability lost, III - self-service ability lost.​

Diagnostic measures

​Arthritis and polyarthritis caused by other specified bacterial pathogens Use an additional code if necessary to identify the bacterial agent (​

6-8 mg / day, maintenance dose - 2-4 mg / day.

• Destination schemes
• No
• Arthritis in Bechterew's disease, gout (rare);
• Suppression of the inflammatory and immunological activity of the process.

Inflammation of the mucous membrane of the eyes occurs (may develop conjunctivitis).

Treatment tactics

Methotrexate remains the "gold standard" of basic therapy for RA, which has the best ratio of efficacy/toxicity. Assign to patients with active RA or those with risk factors for poor prognosis (see above) at a dose of 7.5-15 mg per week. The term of the effect is 1-2 months. Among the side effects of methotrexate are hepatotoxicity, myelosuppression, so the control of KLA and transaminases should be performed monthly. An increase in the level of liver enzymes is a signal to reduce the dose of the drug or completely cancel it. A persistent increase in liver enzymes after discontinuation of the drug is an indication for a liver biopsy. Taking into account the antifolate mechanism of action, folic acid 1 mg / day is indicated, except for the days of methotrexate use.

Frequency - 1% in the general population. The predominant age is 22–55 years. The predominant gender is female (3:1). Incidence: 23.4 population in 2001

Possible side effects

Juvenile rheumatoid arthritis

Symptoms of a stuck joint

psoriatic arthritis (occurs in 10-40% of patients with psoriasis)

ICD-10 code

• Relief of systemic manifestations and articular syndrome.
• An increase in ESR in the UAC.
• ingestion of protein components;
• Pain in the joints becomes stronger, while motor activity decreases. In the affected areas, noticeable redness and swelling appear.
• Hydroxychloroquine (200 mg 2 r / day or 6 mg / kg / day) is a frequent component of combination therapy for active, especially "early" RA. Monotherapy with hydroxychloroquine does not slow radiological progression. The term of the effect is 2-6 months. With long-term treatment, an annual ophthalmological examination, examination of the visual fields is necessary.
• unknown. Various exogenous (viral proteins, bacterial superantigens, etc.), endogenous (type II collagen, stress proteins, etc.) and nonspecific (trauma, infection, allergy) factors can act as "arthritogenic" factors.​
• Due to the fact that the RA treatment regimens indicated in the table are not always effective, several combinations of basic agents are used in practice, among which the combinations of methotrexate with sulfasalazine, methotrexate and delagil are the most common. Currently, the treatment regimen in which methotrexate is combined with anticytokines is considered the most promising.

Epidemiology of juvenile chronic arthritis

Quinoline drugs (delagil - tablets of 0.25 g)

Classification of juvenile chronic arthritis

Reiter's syndrome (according to ICD-10 code 02.3) can develop in two forms - sporadic (causative agent - C. Trachomatis) and epidemic (Shigella, Yersinia, Salmonella).

Preservation of the functional ability of the joints.

Causes of juvenile chronic arthritis

In the subacute course of the disease, the symptoms are less pronounced. First, one joint is affected. Most often it is the ankle or knee joint. Both 1 joint and several can be affected. In the oligoarticular form of the disease, 2-4 joints are affected. Pain syndrome may not be. During a medical examination, swelling and dysfunction of the joint are determined. The movement of a sick child is difficult. The liver and spleen are of normal size. The subacute course proceeds more favorably and is better amenable to therapy.

The organs of the genitourinary system become inflamed.

The pathogenesis of juvenile chronic arthritis

Sulfasalazine is especially indicated in seronegative RA, when differential diagnosis with seronegative spondyloarthropathies is difficult. The starting dose is 0.5 g/day with a gradual increase in dose to 2-3 g/day in 2 divided doses after meals. Taking into account the myelotoxicity of the drug with its long-term use, it is necessary to control the OAC every 2-4 weeks for the first 2 months, then every 3 months.

​70% of RA patients have HLA - DR4 Ag, the pathogenetic significance of which is associated with the presence of a rheumatoid epitope (section b - the chain of the HLA molecule - DR4 with a characteristic amino acid sequence from the 67th to the 74th positions). The effect of the “gene dose” is discussed, that is, the quantitative-qualitative relationship between the genotype and clinical manifestations. The combination of HLA - Dw4 (DR b10401) and HLA - Dw14 (DR b1*0404) significantly increases the risk of developing RA. On the contrary, the presence of antigen defenders, for example HLA - DR5 (DR b1 * 1101), HLA - DR2 (DR b1 * 1501), HLA DR3 (DR b1 * 0301) significantly reduces the likelihood of RA.

Symptoms of juvenile chronic arthritis

In medical practice, there are often cases of lack of effect from treatment (for example, with reactive arthritis, inflammation is not relieved even when taking antibiotics in combination with NSAIDs), when patients remain disease active and the rapid progression of articular deformities.

Diagnosis of juvenile chronic arthritis

Stabilization of lysosomal membranes, inhibition of phagocytosis and neutrophil chemotaxis, inhibition of cytokine synthesis.

Treatment goals for juvenile chronic arthritis

• The clinical picture differs from other types of arthritis, since the accompanying signs of the disease are lesions of the mucous membranes of the oral cavity, prostatitis (in men), vaginitis and cervicitis (in women). A common symptom is inflammation of the eyes (conjunctivitis, iridocyclitis), which manifests itself in reddening of the sclera, the appearance of purulent discharge, swelling of the eyelids.
• ​Prevention or slowdown of joint destruction, disability of patients.​
• It is necessary to know not only the causes and symptoms of juvenile rheumatoid arthritis, but also the methods of its diagnosis. In the early stages of the disease, the symptoms may be mild, so the diagnosis is often difficult.
• Dysfunction of the immune system.
• Initially, the disease can affect only one knee joint, but later it can spread to other joints. A pronounced clinic can be insignificant or very strong, depending on the person's immune system. In the future, it is possible to develop rheumatoid arthritis, which affects the larger joints of the lower extremities and toes. Back pain occurs with the most severe form of the disease.
• Leflunomide is a new cytostatic drug with an antimetabolic mechanism of action, developed specifically for the treatment of RA. Apply at a dose of 10-20 mg / day. The effect develops after 4-12 weeks. Monitoring of toxicity involves monitoring the level of liver enzymes and TAC.​
• The pathological process in RA is based on generalized immunologically conditioned inflammation. In the early stages of the disease, Ag is detected - specific activation of CD4 + - T - lymphocytes in combination with hyperproduction of pro-inflammatory cytokines (tumor necrosis factor, IL - 1, IL - 6, IL - 8, etc. .) against the background of a deficiency of anti-inflammatory mediators (IL-4, a soluble antagonist of IL-1). IL - 1 plays an important role in the development of erosion. IL - 6 stimulates B - lymphocytes to the synthesis of RF, and hepatocytes - to the synthesis of proteins of the acute phase of inflammation (C - reactive protein, etc.). TNF-a causes the development of fever, pain, cachexia, is important in the development of synovitis (it promotes the migration of leukocytes into the joint cavity by enhancing the expression of adhesion molecules, stimulates the production of other cytokines, induces the procoagulant properties of the endothelium), and also stimulates the growth of pannus (granulation tissue penetrating into the cartilage from the synovial tissue and destroying it). An important prerequisite is the weakening of the endogenous synthesis of HA - hormones. In the late stages of RA, under conditions of chronic inflammation, tumor-like processes are activated due to somatic mutation of fibroblast-like synovial cells and defects in apoptosis.​

Forecast

Doctors make a conclusion about the need to change the therapy program if the patient has been treated for six months using at least three basic drugs.

The initial stage of RA.

​Laboratory research methods​

Arthritis of the knee joint should be differentiated from other pathological processes, the most common of which are arthrosis and bursitis. Bursitis, which is an inflammation in the synovial bag, can be easily distinguished from arthritis by an experienced specialist at the first appointment.

Prevention of juvenile chronic arthritis

The main diagnostic methods are:

Causes, symptoms, diagnosis and treatment of knee arthritis

Of the viral infections, the most dangerous are those caused by the Epstein-Barr virus, parvovirus, and retroviruses. The mechanism of the development of the disease is associated with autoimmune disorders. When exposed to any adverse factor in the body of a child, special immunoglobulins are formed. In response to this, the synthesis of rheumatoid factor occurs. Joint damage occurs. In this case, the synovial membranes and blood vessels, cartilage tissue are affected. Not only the joints, but also the marginal parts of the bones (epiphyses) can be destroyed. The resulting circulating immune complexes are carried through the blood vessels to various organs. At the same time, there is a risk of developing multiple organ failure.

Etiology

In rare cases, the disease can affect the central nervous system, give complications to the organs of the cardiovascular system.

Gold salts (eg, sodium aurothiomalate) are used to treat seropositive RA. Trial dose 10 mg IM, then 25 mg weekly, then 50 mg weekly. As the total dose of 1000 mg is reached, they gradually switch to a maintenance regimen of 50 mg 1 time in 2-4 weeks. The effect develops in 3–6 months. Among the side effects are myelosuppression, thrombocytopenia, stomatitis, proteinuria, therefore OAC and OAM are recommended to be carried out 1 time in 2 weeks.

Evidence of the ineffectiveness of therapy is the negative dynamics of laboratory tests, the preservation of the focus of inflammation. In this case, you need an alternative solution on how to treat knee arthritis. Medical statistics confirms the positive dynamics in the use of pulse therapy using hormonal drugs (methylprednisolone intravenously, isotonic solution for three days - three courses are repeated after one month). Methylprednisolone is prescribed with caution in combination with cyclophosphamide due to the high toxicity of the drugs.

2 tab. per day for the first 2-4 weeks, then 1 table. per day for a long time.

Arthritis in children

Firstly, with bursitis, the mobility of the knee is slightly limited, and secondly, the area of ​​articular inflammation has clear contours. On palpation, the doctor quickly determines the boundaries of the inflammatory focus. As for arthrosis, it is more difficult to differentiate, since these diseases, which have completely different etiologies, have many similar signs.

Improving the quality of life of patients.

Symptoms of the disease

JRA classification according to ICD 10 takes into account the type of joint damage. Allocate polyarthritis and oligoarthritis. ICD 10 divides arthritis into acute and subacute. There is a classification that takes into account the clinical symptoms of the disease.

Today, to confirm whether a patient really has reactive arthritis, a whole range of laboratory tests is needed. Various specialists are involved in the examination of the patient. It is necessary to be examined by a gynecologist, urologist and therapist. The attending physician will indicate the need for examination by other medical specialists. After collecting the results of laboratory tests, anamnesis data, identifying clinical manifestations, the use of certain drugs is prescribed.

Cyclosporine is rarely used in the treatment of RA, only in cases of refractory to other drugs. The dose is 2.5–4 mg/kg/day. The effect develops in 2–4 months. Side effects are serious: arterial hypertension, impaired renal function.

Pyogenic arthritis, unspecified. Infectious arthritis NOS

Degrees of dysfunction

A new direction in the treatment of rheumatoid arthritis is therapy involving the use of so-called biological agents (biologic agents). The action of the drugs is based on the inhibition of the synthesis of cytokines (TNF-α and IL-1β).

Dyspeptic phenomena, skin itching, dizziness, leukopenia, retinal damage.

Do not reveal specific abnormalities

Arthrosis is a degenerative process in cartilage and bone tissue that occurs when there is a metabolic disorder, not associated with an inflammatory component. The main group of patients is the elderly (by the age of 60, most people are diagnosed with dystrophic changes in the joints).

Types of arthritis

Minimizing the side effects of therapy.

• external examination of the child;
• In this case, the following forms of juvenile arthritis are distinguished:
• It is necessary to begin treatment of reactive arthritis with the destruction of the infectious focus, that is, the causative agents of the original disease. To do this, you need to undergo a comprehensive examination of the whole organism. After determining the pathogen, sensitivity to drugs is established. A bacterial infection is treated with antibiotics.​
• Azathioprine is used at a dose of 50–150 mg/day. The effect develops in 2-3 months. Laboratory monitoring is required (OAC every 2 weeks, then every 1–3 months).​
• Fatigue, subfebrile condition, lymphadenopathy, weight loss. 2.​
• Excludes: arthropathy in sarcoidosis (​
• It has been reliably established that in 60% of patients with active rheumatoid articular syndrome, even with the third degree of the disease, there is a decrease (or absence) of the progression of articular changes during maintenance therapy with Remicade. However, the use of this form of treatment is justified if the basic therapy did not give the expected effect.

Sulfa drugs (sulfasalazine, salazopyridazine) - 500 mg tablets

Instrumental research methods

Differential Diagnosis

Arthritis is always inflammation, which over time, with the progression of the disease (with an autoimmune nature), spreads to the entire body. That is why there are many accompanying signs in autoimmune arthritis - this is fever, subfebrile temperature, headache, and general malaise. With rheumatoid arthritis, the cardiovascular system is seriously affected.

Treatment of juvenile chronic arthritis

The use of antibacterial drugs is recommended at the initial, most acute stage of the disease. In the future, their use becomes less effective. In some cases, symptomatic treatment is prescribed, in which non-steroidal drugs are used, for example, ibuprofen. "Anti-cytokine" therapy for RA is based on the suppression of the main pro-inflammatory cytokines: TNF-a and IL-1. Registered in Russia, infliximab is a monoclonal antibody to TNF - a. Infliximab is used at a dose of 3 mg/kg IV every 2, 6, and then every 8 weeks. The onset of the effect is from several days to 4 months. Articular syndrome

Diagnosis of arthritis of the knee

Mortality in juvenile arthritis is low. Most deaths are associated with the development of amyloidosis or infectious complications in patients with a systemic variant of juvenile rheumatoid arthritis, often resulting from long-term glucocorticoid therapy. In secondary amyloidosis, the prognosis is determined by the possibility and success of treating the underlying disease.

Treatment is carried out only after diagnosis. It is required to exclude such diseases as ankylosing spondylitis, psoriatic arthritis, reactive arthritis, Reiter's syndrome, systemic lupus erythematosus, tumor, ankylosing spondylitis. In the presence of rheumatic diseases in children, treatment should be comprehensive.

involvement in the process of joints;

The 10th International Classification of Diseases (ICD 10) lists varieties of pathologies of the joints and connective tissues under the codes M05 (seropositive), M06 (seronegative) and M08 (juvenile) rheumatoid arthritis. Rheumatoid polyarthritis is classified, which in the ICD is under the M13.0 code, like other arthritis, depending on the presence of rheumatoid factor in the blood.

Long-term outpatient observation.

Tendosynovitis in the area of ​​the wrist joint and hand Bursitis, especially in the area of ​​the elbow joint Damage to the ligamentous apparatus with the development of hypermobility and deformities Muscle damage: muscle atrophy, myopathies, more often medicinal (steroid, as well as while taking penicillamine or aminoquinoline derivatives). 4.​

Balneological therapy is a very effective procedure in a comprehensive program for the treatment of arthritis of the knee joint. However, this direction of rehabilitation is indicated for those patients who do not have serious diseases of the cardiovascular system, malignant neoplasms, and have not previously had heart attacks or strokes. All procedures using therapeutic biological components are prescribed with great care.​

Inhibition of the functional activity of macrophages and neutrophils, inhibition of the production of immunoglobulins and RF.

Treatment

Due to the fact that the etiology of juvenile rheumatoid arthritis is unknown, primary prevention is not carried out.

Treatment of juvenile rheumatoid arthritis includes restriction of motor activity, avoidance of insolation, use of NSAIDs to eliminate pain and inflammation, immunosuppressants, exercise therapy, physiotherapy.

• a slight increase in body temperature;
• Polyarthritis is understood as systemic multiple lesions of the joints, in which not only almost all types of joints become inflamed and destroyed, simultaneously or sequentially, but also other organ systems. Sometimes the result of a neglected form of polyarthritis can be disability. Rheumatoid polyarthritis can act as an independent disease as an infectious-nonspecific rheumatoid arthritis, and sometimes it is a consequence of other diseases - sepsis, gout, rheumatism. Even those who have bad teeth should be wary of the disease, but the word "dentistry" is unacceptable in the lexicon.
• Observation is carried out jointly with a specialist - a rheumatologist and a district (family) doctor. The competence of a rheumatologist includes making a diagnosis, choosing a treatment strategy, teaching the patient the correct regimen, and conducting intra-articular manipulations. General practitioners are responsible for organizing the systematic management of the patient; they also carry out clinical monitoring. During each visit, the patient is assessed: the severity of pain in the joints on a point scale, the duration of morning stiffness in minutes, the duration of malaise, the number of swollen and painful joints, and functional activity.
• Systemic manifestations
• A39.8

Since there are many varieties of arthritis and joint pathologies, it is necessary to consult a doctor at the first signs of the disease. The sooner the causes of the inflammatory process are determined, the more likely it is to cure the disease completely.

Anemia, an increase in ESR, an increase in CRP levels correlate with RA activity Synovial fluid is turbid, with low viscosity, leukocytosis is above 6000/µl, neutrophilia (25–90%) RF (AT to IgG class IgM) is positive in 70–90% of cases ANAT, AT to Ro / La OAM (proteinuria in the framework of nephrotic syndrome caused by amyloidosis of the kidneys or drug-derived glomerulonephritis) are detected in Sjögren's syndrome. An increase in creatinine, blood serum urea (assessment of renal function, a necessary stage in the selection and control of treatment).

The disease is not limited by age, but middle-aged women are diagnosed with this diagnosis somewhat more often than the representatives of the stronger half. An exception is infectious reactive arthritis, which is diagnosed mainly in older men (more than 85% of patients with reactive arthritis are carriers of the HLA-B27 antigen).

Depending on the type of classification, the disease has the following names: juvenile arthritis (ICD-10), juvenile idiopathic arthritis (ILAR), juvenile chronic arthritis (EULAR), juvenile rheumatoid arthritis (ACR).

Often, the joints in the cervical spine are involved in the process. Articular syndrome is characterized by:

New methods

This disease is difficult to treat. The only thing that patients can hope for is a long-term remission, when the hospital does not become a second home. In the early stages, this can often be achieved, but in most cases, the symptoms recur and even worsen.

​Assess and infer rate of improvement (20%, 50%, 70%) using scores swollen joint scores tender joint scores of at least 3 out of 5 scores overall activity score by patient overall activity score by clinician patient scores of pain acute phase blood counts (ESR, CRP) disability (quantified using standardized questionnaires).​

Arthritis and movement. Gordon N.F.​

Rehabilitation programs

Suppression of collagen synthesis, inhibition of the activity of type I T-helpers and B-lymphocytes, destruction of the CEC

Arthritis of the knee joint can be diagnosed at home if you carefully examine the symptoms of the disease. Regardless of the etiology, symptoms such as swelling, redness in the joint area, general malaise, external signs of deformation of the articular tissue appear.

​Unlimited (any age)​

It is worth dwelling in more detail on rheumatoid arthritis (RA), which is an autoimmune disease with an unclear etiology. The disease is a common pathology - about 1% of the population suffers. Very rarely there are cases of self-healing, in 75% of patients there is a stable remission; in 2% of patients, the disease leads to disability.​

M08. Juvenile arthritis.

Stiffness in the morning lasting up to 1 hour or more;

1. The goal of therapy for rheumatoid arthritis is to reduce rheumatic pain, reduce inflammation, improve joint mobility and prevent complete immobility of the patient. The basic principles that guide any clinic that treats rheumatoid arthritis are complexity and consistency. Well-proven spa treatment through therapeutic mud.
2. Rehabilitation.
3. American Rheumatological Association (1987)

ICD 10. Class XIII (M00-M25) | Medical practice - modern medicine of diseases, their diagnosis, etiology, pathogenesis and methods of treatment of diseases

Peripheral joints and systemic inflammatory lesions of internal organs.

2 Shoulder Humerus Elbow Bone

High clinical and laboratory activity of RA

However, one should not wonder how to treat arthritis of the knee joint on their own, especially using dubious recipes of folk medicine. This can lead to irreversible consequences. The decision on how to treat knee arthritis is made only after a comprehensive examination.​

As a rule, older

With this disease, the inner surface of the joints (cartilage, ligaments, bones) is destroyed and replaced by scar tissue. The rate of development of rheumatoid arthritis is not the same - from several months to several years. Features of the clinical picture of one or another type of inflammation of the joints make it possible to suspect the disease and prescribe the necessary examinations to confirm the diagnosis. In accordance with ICD-10, RA is classified as seropositive (code M05), seronegative (code M06), juvenile (code MO8)

M08.0. Juvenile (juvenile) rheumatoid arthritis (seropositive or seronegative).​

swelling in the joint area;

The first stage is the suppression of the autoimmune process, which actually leads to the destruction of tissues, pain, loss of the ability to move. This is followed by anti-inflammatory treatment, complete cleansing of the body from toxic metabolic products. During the period of remission, they restore blood circulation, increase the efficiency of joints, and normalize metabolism. All these stages combine both medical and physiotherapeutic methods of treatment.​

INFECTIOUS ARTHROPATHY (M00-M03)

Physical therapy plays an important role. Sanatorium - resort treatment is recommended during the period of minimal activity or remission. To correct deformities, orthoses are used - individual orthopedic devices made of thermoplastic, worn at night.​​At least 4 of the following Morning stiffness > 1 hour International Classification of Diseases Code ICD-10: 3 - bone, ulna Initial dose of 250 mg / day with a gradual increase to 500-1000 mg / day; maintenance dose - 150-250 mg / day

M00 Pyogenic arthritis

Physicians must determine the nature of the disease in order to prescribe adequate treatment. Orthopedic traumatologists, surgeons, rheumatologists give directions for laboratory and instrumental studies. The treatment regimen is developed by a specialized specialist (it can be a phthisiatrician, dermatologist-venereologist, cardiologist and other doctors). Nature of the process Some types of arthritis affect only children and adolescents, so they should be singled out in a separate row. M08.1. Juvenile (juvenile) ankydotic spondylitis. Painfulness; The basic treatment is the suppression of the autoimmune process through such drugs: methotrexate, sulfasalazine and leflunomide. In terms of minimizing side effects, the latter differs, this should be taken into account from the position that they all require long-term (at least six months) use. Features in pregnant women Arthritis M06 - 4 Hand Wrist, Joints between these fingers, bones, metacarpus Skin rash, dyspepsia, cholestatic hepatitis, myelosuppression code M08) affects children after bacterial and viral infections. As a rule, one knee or other large joint becomes inflamed. The child has pain with any movement, swelling in the joint area. Children limp, hardly get up in the morning. In the absence of treatment, joint deformity gradually develops, which is no longer possible to correct.

M08.2. Juvenile (juvenile) arthritis with a systemic onset, a change in gait; Non-steroidal anti-inflammatory drugs (NSAIDs) also have an analgesic effect. But they should also be used for a long time, so the doctor must choose the one that is best tolerated by the patient. Among non-steroids, diclofenac, ibuprofen, nimesulide are widely used. All of them affect the gastrointestinal tract to a greater or lesser extent. Pregnancy improves the course of RA, however, after delivery, a relapse always occurs due to hyperprolactinemia. NSAIDs in the first trimester of pregnancy and 2 weeks before delivery are undesirable (in the first trimester - the risk of a teratogenic effect, before childbirth - the threat of developing weakness of labor, bleeding, early closure of the ductus arteriosus in the fetus). Gold salts, immunosuppressants are contraindicated for pregnant women. There is evidence of the relative safety of the use of aminoquinoline drugs and sulfasalazine, however, the expected effect should be correlated with the possible risk. 3 joints or more

​Other rheumatoid arthritis​​5 Pelvic Gluteal Hip joint, area and thigh area, sacroiliac, femoral joint, bone, pelvis Methotrexate (tablets 2.5 mg, ampoules 5 mg) Second stage - laboratory tests blood (with inflammation, there is an increase in ESR, leukocytosis, an inflammatory marker CRP, and other specific reactions).

Arthritis rheumatoid, Diseases and treatment of folk and medicinal products. Description, application and healing properties of herbs, alternative medicine

• Always chronic

Arthritis rheumatoid: Brief description

Reactive childhood arthritis (ICD-10 code MO2) manifests itself two weeks after an intestinal infection. If the process develops in the knee joint, then external signs are clearly visible: the skin turns red, swelling without pronounced boundaries is visible under the patella. The child often has a fever, which is reduced by antipyretic drugs, but pain in the knee area remains. M08.3. Juvenile (juvenile) polyarthritis (seronegative). Dysfunction of the affected area of ​​the body. It happens that non-steroidal drugs are not able to alleviate the suffering of the patient, so the clinic decides on the use of glucocorticosteroid (GCS) drugs - hormones that can be injected directly into affected joint. GCS have a lot of side effects, but they are prescribed in short courses, which significantly reduces the risk.

​The factors for an unfavorable prognosis of RA include: seropositivity in the Russian Federation at the onset of the disease female gender young age at the onset of the disease systemic manifestations high ESR, significant concentrations of CRP carriage of HLA-DR4 early onset and rapid progression of erosions in the joints low social status of patients.

6 Calf Fibula Knee joint, bone, tibia Folic acid antagonist; inhibits the proliferation of T- and B-lymphocytes, the production of antibodies and pathogenic immune complexes. The third stage is radiography. In the presence of arthritis, a curvature of the articular surface, bone ankylosis is detected. Onset of the disease In addition to infectious, reactive, rheumatoid arthritis, children are often diagnosed with an allergic disease. The disease begins in a child suddenly - immediately after allergens enter the bloodstream. The joints quickly swell, there is shortness of breath, urticaria. Quincke's edema, bronchial spasm may develop. When the allergic reaction is eliminated, signs of arthritis disappear. M08.4. Pauciarticular juvenile (juvenile) arthritis. If juvenile arthritis affects the small joints of the fingers or toes, then deformity of the fingers is possible. In the articular form of arthritis, damage to the organs of vision is often observed. Iridocyclitis or uveitis develops. This may reduce visual acuity. The seronegative form of arthritis is more mild than the seropositive form. In the latter case, rheumatoid nodules are often detected in the area of ​​​​the joints. Modern medicine treating rheumatoid arthritis uses new biological products that inhibit protein activity. These drugs include etanercept (Enbrel), infliximab (Remicad), and adalimumab (Humira). They have significantly fewer side effects, and they give a positive result. Arthritis of the joints of the hands Symmetrical arthritis 7 Ankle Metatarsus, Ankle joint, Tarsal joint and foot, other joints of the foot, toes RA with systemic manifestations , high activity of RA, low efficiency of other basic means. Fourth stage - MRI, ultrasound (assigned to differentiate arthritis from arthrosis, Bechterew's disease and bursitis). With erased signs that occur during a sluggish chronic process, additional hardware studies of the joint may be prescribed - tomography of the articular tissue, CT, pneumoarthrography. Acute, sudden Arthritis of the knee joint can develop as an independent disease, or be a complication after injuries and diseases .M08.8. Other juvenile arthritis. With this pathology, other important organs often suffer. With a systemic form of arthritis, there may be:

Statistical data

Arthritis rheumatoid: Causes

Etiology

genetic features

Pathogenesis

Rheumatoid Arthritis: Signs, Symptoms

Clinical picture

​8 Others Head, neck, ribs, skull, trunk, spine​​7.5-25 mg per week orally.​​At the same stage, puncture of the joint and collection of synovial fluid for laboratory examination (if indicated, biopsy) is indicated. Gradual (develops over months, years) Arthritis-affected knee joint swells, pain occurs when it moves. The skin in the joint area changes color (turns red or becomes "parchment"), but this is not a reliable sign of an inflammatory process. M08.9. Juvenile arthritis, unspecified. Exanthema; Folk methods cannot be the only treatment when it comes to polyarthritis. It is better to use them during the remission period, as they are more gentle in terms of side effects. In visible inflammation, chamomile baths have worked well. Arthritis Rheumatoid nodules RF Radiological changes Sensitivity - 91.2%, specificity - 89.3%. Rheumatoid

Arthritis rheumatoid: Diagnosis

Laboratory data

instrumental data

When determining the type and degree of reactive arthritis (ICD-10 code), biological material is examined (general blood and urine tests), urogenital and ophthalmological examinations are performed, a test for the presence of HLA-B27, ECG, thymol test, sial test, ALT determination, AST, inoculation of biological fluids.​​Symptoms​​The main cause of swelling and a visually noticeable increase in the patella is the accumulation of fluid inside the joint. Excessive pressure on the walls of the articular tissue causes severe pain. The volume of fluid steadily increases over time, so the pain syndrome becomes more intense. Juvenile rheumatoid arthritis is one of the most common and most disabling rheumatic diseases that occurs in children. The incidence of juvenile rheumatoid arthritis is from 2 to 16 people of the child population under the age of 16 years. The prevalence of juvenile rheumatoid arthritis in different countries is from 0.05 to 0.6%. Girls are more likely to get rheumatoid arthritis. Mortality is 0.5-1%. Kidney damage by the type of glomerulonephritis; Infusions of birch buds, tricolor violet, nettle, hernia are taken orally. They also use the collection of herbs, which includes wild rosemary, chamomile, string, lingonberries, juniper (berries). This collection of half a glass three times a day before meals is very effective in exchange polyarthritis. early stages of RA, active therapy (NSAIDs at an adequate dose + basic drugs) should be started within the first 3 months after the diagnosis of definite RA. This is especially important in patients with risk factors for an unfavorable prognosis, which include high RF titers, a pronounced increase in ESR, damage to more than 20 joints, the presence of extra-articular manifestations (rheumatoid nodules, Sjogren's syndrome, episcleritis and scleritis, interstitial lung damage, pericarditis, systemic vasculitis). , Felty's syndrome). The use of GC is indicated in patients who do not "respond" to NSAIDs or have contraindications to their appointment in an adequate dose, and also as a temporary measure before the onset of the effect of basic drugs. Intra-articular administration of HA is intended for the treatment of synovitis in 1 or several joints, which complements, but does not replace, complex treatment. Arthritis Disorders predominantly affecting peripheral joints (limbs)

Arthritis rheumatoid: Methods of treatment

Treatment

General tactics

Mode

In addition, uric acid crystals, which look like thin needle-shaped spikes, are deposited in the joint. They injure small vessels, which is the basis for the development of associated infections. In adolescents, there is a very unfavorable situation for rheumatoid arthritis, its prevalence is 116.4 per (in children under 14 years old - 45.8 per), the primary incidence is 28, 3 per (in children under 14 years old - 12.6 per).​

Pericarditis; In the period of remission, pepper rubs with kerosene are also used. Such procedures not only relieve pain and inflammation, but also penetrate the blood, partially cleansing it. Both in the hospital and at home, cold treatment can be applied. In the hospital, cryosaunas are used - special cabins with chilled air, which are replaced at home with ice packs. After the procedure, which lasts about 10 minutes, the joints are massaged and kneaded. For one procedure, cooling is performed three times. Duration of treatment - 20 days.​

ICD-10 Patients should form a movement stereotype that counteracts the development of deformities (for example, to prevent ulnar deviation, open a tap, dial a phone number and other manipulations not with the right hand, but with the left hand).​​: polyarthritis, oligoarthritis, monoarthritis Rheumatoid Note Inhibition of the proliferative activity of T- and B-lymphocytes.

Despite the leading role of radiography in the diagnosis of arthritis, it must be remembered that in the early stages of the disease, pathological changes are not always visible in the pictures. Arthrography is of informative value for physicians in the study of large joints, and in case of polyarthritis this diagnostic method is not effective. Serological tests are used to identify the causative agent of arthritis of an infectious nature.

Manifested with changes in cartilage and bone tissue

Arthritis of the knee is difficult not only because of the intense pain syndrome, but also due to disruption of the functioning of functional systems. The cardiovascular and endocrine systems are particularly affected. There is shortness of breath, tachycardia, low-grade fever, sweating, circulatory disorders in the limbs, insomnia and other non-specific signs.

Three classifications of the disease are used: the American College of Rheumatology (ACR) classification of juvenile rheumatoid arthritis, the European League Against Rheumatism (EULAR) classification of juvenile chronic arthritis, and the International League of Rheumatological Associations (ILAR) classification of juvenile idiopathic arthritis.

inflammation of the heart muscle;

Pay special attention to diet. Healers recommend a raw-food diet, especially the widespread use of eggplant in food. In any case, rheumatoid arthritis can be curbed without letting it spoil the patient's quality of life.

M05 Seropositive rheumatoid

RA with systemic manifestations.

Treatment of arthritis is a long process and requires not only the implementation of the doctor's recommendations regarding drug therapy, but also the passage of rehabilitation courses. Pain intensity

Surgery

Classification of juvenile chronic arthritis

Any arthritis, put in the ICD 10 under the codes M05, M06, M08, M13.0, requires constant attention, since even a long remission will not help to avoid a spontaneous exacerbation of the disease.

Non-steroidal anti-inflammatory drugs

with systemic manifestations Special syndromes: Felty's syndrome, Still's syndrome in adults This group covers arthropathies caused by microbiological agents

150 mg / day, maintenance dose - 50 mg / day. The diet for arthritis of the knee must be strictly observed. Excluded food rich in carbohydrates, smoked meats, fatty meats, legumes. With the transfer to dietary nutrition and the use of individual therapy, a positive effect is observed. In general, the treatment of arthritis of the knee joint includes the following areas:

Strongly expressed from the very beginning of the disease

The first degree is characterized by a moderate pain syndrome, there is a slight limitation of movement when rotating the knee, when lifting or while squatting.

Forecast

Synonyms

Abbreviations

By seroprescription Myelosuppression, activation of foci of chronic infection. Medications (tablets, injections, ointments, gels);

Moderate at first, gradually increasing

Rheumatoid arthritis- a chronic inflammatory disease of the connective tissue, characterized by its own immune response, of a systemic nature.

The causes of the disease are still unknown. Large articular joints, which are located on the periphery of the body, are mainly affected. In the structure of the joint, erosion and destruction of all tissue structures occur.

Population rheumatoid arthritis affects 1% of the population. Women get sick 4 times more often than men. The disease occurs at any age, but most often in 40-50 years.

The main peak of incidence falls on 30-35 years.
After 1 year of illness, every 3-4 patients experience erosive changes in the articular apparatus, which is the cause of a decrease in performance.

Causes of rheumatoid arthritis

In the modern world, medical science cannot give an exact answer about the cause of rheumatoid arthritis.
Risk factors are identified that, to one degree or another, can lead to a change in the autoimmune response to their own mediators.

Main risk factors:

1. Genetically mediated predisposition. presence of specific antigens.
2. congenital deformity musculoskeletal system.
3. Hormonal imbalance during pregnancy, taking oral contraceptives and breastfeeding. Postmenopausal women.
4. Toxic effect of nicotine on connective tissue (smoking).
5. Various infectious agents(mycobacteria, intestinal infections, toxins).
6. Non-specific agents(trauma, hypothermia, abortion).
7. Specific proteins produced during heat shock.

Triggers for the development of rheumatoid arthritis:

• Acute infectious diseases.
• The period of exacerbation of a chronic disease.
• Climate change.
• Puberty.
• Menopause.
• The period after childbirth.
• Injury.
• stress reactions.

Types and codes of rheumatoid arthritis according to ICD-10

Rheumatoid arthritis- polymodal disease and different variants of its manifestation are possible. The mechanism of formation and migration of the inflammatory process in the joints is unclear.

Main types

1. Articular form of rheumatoid arthritis:
   • M05.8 - Other seropositive rheumatoid arthritis
   • M06.0 - Seronegative rheumatoid arthritis
   • M08.0 - Juvenile rheumatoid arthritis
   • M08.1 - Juvenile ankylosing spondylitis
   • M08.3 - Juvenile polyarthritis
2. Rheumatoid arthritis involving internal organs or systemic lesions:
   • M05.0 - Felty's syndrome
   • M05.1 - Rheumatoid lung disease
   • M05.2 - Rheumatoid vasculitis
   • M06.1 - Adult Still's disease
   • M06.2 - Rheumatoid bursitis
   • M06.3 - Rheumatoid nodule.
   • M06.4 - Inflammatory polyarthropathy
   • M08.2 - Juvenile rheumatoid arthritis with systemic onset
   • M35.0 - Sjögren's syndrome.

Presented disease codings are used in the International Classification of Diseases

The assignment of one of the codes should be accompanied by a detailed study and on its basis the issue of detailing the disease according to ICD-10 is decided. Perhaps a combination of several encodings in one clinical case.

Degrees of the disease

Since rheumatoid arthritis is an independent nosological unit, there are degrees of progression of the process, which are based on a number of clinical and instrumental research methods.

These include:

1. clinical stage.
2. Degrees of activity.
3. X-ray stage.
4. functional class.

Clinical stage

It is established on the basis of the time interval, from the first manifestations of the disease.

• Very early stage- the duration of the disease from the first manifestations, no more than 6 months.
• Early stage- duration from 6 months to a year.
• Expanded stage- the disease lasts more than 1 year, with the presence of clinical symptoms.
• late stage- the disease period is more than 2 years. Significant damage to small joints and symmetrical destruction of the main large joints with the formation of multiple erosions.

The degree of disease activity

• Low- clinical symptoms are poor, exacerbations up to 1 time per year.
• Moderate- pronounced clinical picture, exacerbation of pain up to 4 times a year. Damage to one target organ.
• High- constant pain syndrome. Violation of the function of movement. Complications from many physiological systems.
• Remission- absence of clinical signs of the disease.

Function class

Used to assess labor activity and self-service functions. Needed to assess the progression of the disease.

• Functional class 1- the ability to perform standard physical activity is preserved.
  Daily and professional activities are not disturbed.
• Functional class 2- the ability to perform daily activities is preserved, but there is a restriction in the non-professional area.
• Functional class 3- the performance of daily work is preserved, but there are restrictions in the professional and non-professional areas.
• Functional class 4- persistent violations in self-service. Inability to perform professional activities.

Clinical picture

The symptomatology of the disease consists of several variants of the course of rheumatoid arthritis.

• Classic variant- multiple lesions of the small joints of the hands and feet. Has a symmetrical character.
• Monoarthritis- large joints are affected.
• Polyarthritis with damage to small and large joints, after suffering an infectious disease.

With all variants of the onset of the disease, the onset of severe symptoms is noted, which is progressive in nature over time.

Main symptoms:

• General weakness.
• Hyperhidrosis.
• Rarely, the rise of subfebrile temperature in the evening.
• Muscle weakness, up to malnutrition and atrophy.
• Morning stiffness in small joints of hands, large joints. Passes after the beginning of an exercise stress.

As the process progresses, the joints deform. There are persistent contractures and limited movement. A change in the joints of the hand causes deformity like a walrus flipper.

Perhaps the occurrence of extra-articular changes:

1. Damage to the heart with the development of rheumatic pericarditis.
2. Damage to blood vessels, internal organs.
3. Chronic inflammation of the muscular system.
4. Damage to the lungs (interstitial pulmonary fibrosis).
5. Kidney damage (renal amyloidosis, glomerulonephritis).
6. Lymphadenopathy.
7. Systemic liver damage.
8. The occurrence of complications from the gastrointestinal tract.

Diagnostics

Diagnostic measures consist of four main types of research:

1. Anamnesis.
2. Physical examination.
3. Laboratory research.
4. Instrumental research methods.

Anamnesis

• Complaints.
• The moment of pain or stiffness in the joints.
• The degree of restriction of labor activity.
• Recent infectious diseases.
• Allergy history.
• Heredity.

Physical examination

• Each joint is examined in detail.
• Mobility is assessed.
• Auscultation of the heart and brachycephalic arteries is performed.
• The skin is examined to assess their condition.

Laboratory research

• General blood analysis.
• Clinical blood test.
• General urine analysis.
• Biochemistry of blood.
• lipid spectrum.

Instrumental research methods

• Radiography.
• CT scan.
• Magnetic resonance imaging.

The appointment and subsequent evaluation of the result of the diagnosis should be handled by a doctor.

Treatment of rheumatoid arthritis

Modern therapy consists in taking two main groups of drugs:

1. Fast-acting drugs (NSAIDs, glucocorticosteroids). They are designed to quickly relieve pain and eliminate the inflammatory reaction in the joint. Do not affect the course of the disease.
2. Basic preparations (methotrexate, cuprenil, plaquenil, arava). They are able to delay the development of erosion and the occurrence of ankylosis. Thanks to these properties, they preserve the functionality of the joints.

It is necessary to modify the lifestyle, with a change in the motor stereotype

New generation drugs

In the modern world, there are few new dosage forms to curb the progression of the disease.

The main groups of drugs:

• Aminoquinolines.
• Sulfonamides.
• Salts of gold.
• Cytostatic immunosuppressants.
• Biological modifiers of the immune response.

The choice of the drug in the treatment of rheumatoid arthritis should be dealt with only by the attending physician, under the control of clinical blood counts and X-ray picture

Possible Complications

Complications of the disease are usually associated with the involvement of internal organs and systems in the process.

The most frequent complications:

• Rheumatoid pericarditis.
• Amyloidosis of the kidneys.
• Intestinal amyloidosis.
• Seropositive keratoconjunctivitis.
• Osteoporosis.
• Increased bone fragility.

Most complications occur in the later stages of the disease.

Complications with long-term drug therapy:

1. Violation of the function of the gastrointestinal tract.
2. Hormonal imbalance.
3. Acute renal, hepatic insufficiency.
4. Headache.
5. Nausea, vomiting.
6. Constipation, diarrhea.

In case of complications, it is necessary to urgently seek help from a medical and diagnostic institution.

Prevention

Prevention consists in lifestyle modification and constant medication.

Necessary:

• Avoid drafts.
• Wear warm clothes.
• Resume taking NSAIDs in stressful situations and irrational physical activity.

There are no strict rules in prevention. None of the methods guarantee protection against the occurrence of rheumatoid arthritis.