RHEUMATOID ARTHRITIS
RIB
R
rheumatoid arthritis A type of
arthritis
in which the
joints
in the fingers, wrists,
toes, or elsewhere in the body become
painful, swollen, stiff, and, in severe
cases, deformed. Tissues outside the
joints, such as the heart, can also be
affected. Rheumatoid arthritis is an
autoimmune disorder
that usually starts
in early adulthood or middle age but
can also develop in children (see
juve-
nile chronic arthritis
) or elderly people.
Women are affected more often than
men. There are usually recurrent attacks.
Symptoms are mild fever and aches
followed by swelling, redness, pain, and
stiffness in the joints.
Ligaments
,
ten-
dons
, and
muscles
around the joint may
also become inflamed.
Raynaud's phe-
nomenon
may occur in the fingers, and
swelling of the wrist may cause
carpal
tunnel syndrome
and
tenosynovitis
. Com-
plications caused by severe rheumatoid
arthritis include
pericarditis
,
ulcers
on
the hands and feet,
pleural effusion
,
pul-
monary fibrosis,
and
Sjogren's syndrome.
A diagnosis can be confirmed through
X-rays
and
blood
tests.
Treatments
include
non-steroidal anti-inflammatory
drugs
(NSAIDs);
antirheumatic drugs,
such as
gold, penicillamine,
or
sul-
fasalazine;
and
immunosuppressants,
such as
azathioprine
or
corticosteroids
.
Corticosteroid drugs may also be inject-
ed into the joints.
Physiotherapy
is needed to prevent or
limit deformity or to help relieve symp-
toms and maintain mobility. People
who are disabled by arthritis can be
helped to cope with everyday tasks
through
occupational therapy
.
In severe cases, surgery may be per-
formed to replace damaged joints with
artificial ones (see
arthroplasty
). Most suf-
ferers must take drugs for life, but many
can achieve a near-normal level of activ-
ity with effective control of symptoms.
rheumatoid spondylitis See
ankylos-
ing spondylitis.
rheumatology The branch of medicine
concerned with the causes, develop-
ment,
diagnosis,
and
treatment
of
diseases that affect the
joints
,
muscles
,
and
connective tissue.
rhinitis Inflammation of the
mucous
membrane
lining the nose, which may
cause stuffiness, nasal discharge, and
sneezing. The most common causes are
the common cold (see
cold,
common),
which leads to viral rhinitis, and
allergy
,
which causes allergic rhinitis.
rhinitis, allergic Inflammation of the
mucous membrane
lining the nose due
to
allergy
to pollen, dust, or other air-
borne substances. Also called hay fever,
it causes sneezing, a runny nose, and
nasal congestion.
Antihistamine drugs
and topical
corticosteroid drugs
are
used to treat mild attacks. The drug
sodium cromoglicate, inhaled regularly
throughout the pollen season, may help
to prevent attacks. Long-term relief of
symptoms can sometimes follow desen-
sitization to a pollen allergen by a course
of injections (see
hyposensitization
).
rhinophyma Bulbous deformity and red-
ness of the
nose
that occurs almost
exclusively in elderly men. Rhinophyma
is a complication of severe
rosacea
. The
tissue of the nose thickens, small blood
vessels enlarge, and the
sebaceous glands
become overactive, making the nose
excessively oily. An operation can restore
the nose to a satisfactory shape.
rhinoplasty An operation that alters
the structure of the nose to improve its
appearance or to correct a deformity.
Incisions are made within the nose to
avoid visible scars. The
septum
may be
altered if breathing is blocked and the
cartilage and bone are then reshaped.
The nose is finally splinted in position
for about 10 days. Rhinoplasty usually
causes
considerable
bruising
and
swelling, and the results may not be
clearly visible for weeks or months.
rhinorrhoea The discharge of watery
mucus from the nose, usually due to
rhinitis
. Rarely, the discharge consists of
cerebrospinal fluid and is the result of a
head injury. (See also
nasal discharge.)
rhythm
method See
contraception,
natural methods of
.
rib Any of the flat, curved bones that
form a framework for the chest and a
protective cage around the heart, lungs,
and other underlying organs. There are
12
pairs of ribs, each joined at the back
of the ribcage to a vertebra. The upper 7
pairs, known as “true ribs”, link directly to
the
sternum
by flexible costal
cartilage
.
492
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