Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disorder that primarily affects small peripheral joints. The average annual incidence of RA in the United States is 0.5 per 1000 persons per year. Female : male ratio of 3:1. Onset of the disease can occur at age ranging 20–60 years old. The precise cause of RA is unknown.Major theories mention it’s caused by environmental factors, genetic predisposition or immunogenic.
Diagnosis of RA include morning stiffness at least one hour before maximal improvement, arthritis of three or more joints, arthritis of the hand joints, symmetric arthritis, rheumatoid nodules, positive serum rheumatoid factor and radiographic changes (hand and wrist). Rheumatoid arthritis is defined by the presence of four or more criteria and criteria 1 through 4 must be present for at least six weeks.
A 44 year-old woman with pain and stiffness in her hand on and off since 10 years ago. She had difficulty doing her daily living activities (ADL) such as taking a bath and vocational activities such as cooking and washing clothes. On examination there were range of motion (ROM) limitation of the elbow, wrist and fingers, boutonnière deformity on left middle finger and right little finger. On X-ray examination we found erosion on finger joints.
The rehabilitation program given were ROM exercises, gentle stretching exercises, finger splint and ADL modifications. We advised her to take the rheumatoid medication regularly (meloxicam, methylprednisolon and chloroquin), do exercises, wear the splint, and do the joint protection program. The goals of treatment were pain relief, maintenance of joint range of motion and mobility, further deformity prevent with joint motion modification therefore improving the quality of life.
Wardani, N. K., & Masduchi, R. H. (2019). Rheumatoid Arthritis. Surabaya Physical Medicine and Rehabilitation Journal, 1(1), 33–37. https://doi.org/10.20473/spmrj.v1i1.16169
Pobre T, Rind L. Rheumatological disorders. In: Weiss LD, Weiss JM, Pobre T (eds) Oxford American Handbook of Physical Medicine and Rehabilitation. New York: Oxford University Press, 2010, pp. 258–260.
Tehlirian C V, Bathon JM, Waldburger J-M, et al. Rheumatoid Arthritis. In: Klippel JH, Stone JH, Crofford LJ, et al. (eds) Primer on the Rheumatic Diseases. Boston: Springer, 2008, pp. 114–168.
Boyes C, Fearnley T, Fuller R, et al. The Locomotor System. In: Thomas J, Tanya M (eds) Oxford Handbook of Clinical Examination and Practical Skills. New York: Oxford University Press, 2007, pp. 366–405.
Nucatola TR, Freeman ED, Brown DP. Rheumatology. In: Cuccurullo SJ (ed) Physical Medicine and Rehabilitation Board Review. New York: Demos Medical Publishing, 2010, pp. 81–93.
Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 2010; 62: 2569–2581.
Singh JA, Saag KG, Bridges SL, et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2016; 68: 1–25.
Ramachandran HD. Rheumatoid Arthritis: A Review. world jpurnal Pharm Pharm Sci 2014; 3: 1073–106.
Giavasopoulos EK. REHABILITATION IN PATIENTS WITH RHEUMATOID ARTHRITIS. Heal Sci J 2008; 2: 61–74.
Duci SB. SM Gr up SM Journal of Orthopedics Operative Correction of Boutonniere Deformities in the Rheumatoid Hand. SM J Orthop 2016; 2: 20–22.
Steultjens EE, Dekker JJ, Bouter LM, et al. Occupational therapy for rheumatoid arthritis. Cochrane Database Syst Rev. Epub ahead of print 2004. DOI: 10.1002/14651858.CD003114.pub2.
Suseem, James E, George M. “Outcomes research in rheumatoid arthritis” - Ushering in a new era. Int J Pharm Sci Rev Res 2016; 38: 130–134.
1. The journal allows the author to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions.
3. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution (CC BY).