This is a chronic systemic and non suppurative inflammatory disease of synovial joint.

New diagnosed criteria of Rheumatoid Arthritis

Morning stiffness

Swelling of three or more specificed joint

Swelling in the joint in hand and wrist

Symmetrical swelling

Rheumatoid nodule

Rheumatoid factor +ve

X-ray change erosion

Predisposing Factor

• Heredity- 5-10%
• Trauma - history present
• Race- Disease does not occur in negroes
• Infection- septic foci in teeth, gums, tonsils
• Build- Asthenic bluid 
• Climate- temperate
• Nutrition - nutritional deficiency
• Endocrine Factor- responsible
• Psychic  Factor - aggravated the disease

Aetiology

• Auto immunity is held responsible for this disease.
• Incidence- 1-2%

Clinical Feature

Age- adult and middle age

Sex- female more affected

Onset- gradual (70% cases)

Sometime acute (10-15%)

Predominal symptoms

Ill health

Loss of weight 

Pain

Weakness

Fatigue

Malaise

Excessive sweating palm and sole

Morning stiffness of joint

Increase pulse rate

Raynaud's phenomenon

Gradually swelling of small joint of finger and toes

The proximal interphalangeal joint commonly bear  the 1st burnt of attack

Swollen

Tender

Hot

Spindle shape

Dusky colouration of skin

Morning stiffness gradually became very prominent

Afterward, the disease progressive upward to involve joints like wrist, Ankle, elbow

Ulnar deviation of metacarpophalangeal joint and wrist joint.

Swan neck deformity

Boutonniere's deformity (flexion of proximal interphalangeal joint)

Z deformity of thumb

Other symptoms

Rheumatoid nodule

Fever

Pneumanitis

Articular inflammation

Metacarpal joints are more common

Particularly- index finger

Associated disease

1. Felt's syndrome

In adult patients

In some patients with rheumatoid arthritis

Anaemia

Netropaenia

Thrombocytopenia

Lymphadenopathy

Splenomegaly

Loss of weight

Pigmentation of skin

Remittent fever

Leg ulcer

Neuritis

This is called Felty's syndrome

Sjogren's syndrome

In some case there may be dryness of mouth ( xerostomia) and eyes

Recurrent respiratory infection. 

This is called sjogren's syndrome.

Females are more affected

Average age of onset-50 years

Schirmer's test+ve

Investigation

• Blood examination- ESR increase
• Rheumatoid factor- present
• 19S or 7S Antibody of IgM present
• VDRL-   +ve
• Synovial fluide- show, greenish, turbid colour
• X-ray- affected joint shows- mouse eaten appearance, due to erosion.
• Synovial biopsy

Differential Diagnosis

Rheumatoid Arthritis

Osteoarthritis

Tubercular Arthritis

Traumatic Arthritis

Gonorrheal Arthritis

On Examination

Boggy like swelling of synovial joint

Treatment

NSAID

Calcium

Aspirin

Anti rheumatoid drug

DMARDS

Antacid

Analgesics

Physiotherapy

Repair of joint damage

Splint 

Total joint replacement

Steroids

Homoeopathic medicine for Rheumatoid Arthritis

1. Arnica
2. Rhus Toxiconderdron
3. Calc phos
4. Bryonia

Arnica

Arnica is highly effective remedy for Rheumatoid Arthritis.

Limbs and body ache as if beaten, joints as if sprained.

Great fear of being touch or approached.

Pain in the back and limbs, as if bruised or beaten.

Sprained and dislocated feeling

Soreness after over exertion

Everything on which he lies seems to hard 

Deathly coldness of forearm 

Can not walk erect, on account of bruised pain in pelvic region.

Rheumatism begins low down and works up.

Rhus Toxiconderdron

Rhus Toxiconderdron affects fibrous tissue markedly joints producing pains and stiffness.

Rheumatoid Arthritis in cold season.

Hot painful swelling of joints.

Rheumatic pain spread over a large surface at nape of the neck, loin and extremities, better by motion.

Soreness of condyles of bones.

Limbs stiff.

Tenderness about knee joint.

Tingling in feets.

Tearing asunder pains.

Motion always "limber up" the Rhus Toxiconderdron patient, and hence he feels better for a time from a change of position.

Ailments from strains, overlifting, getting wet while perspiring. 

Calc Phos

Rheumatic pain from draught of air, with stiffness and dullness of head.

Soreness in sacro-iliac symphysis, as if broken.

Stiffness and pain, with cold, numb feeling, worse any change of weather.

Crawling and coldness

Buttocks,back, limbs asleep.

Pains in joints and bones

Weary when going upstairs.

Bryonia Alba

The general character of pain here produced is a stitching, tearing.

Worse by motion, warmth, hot weather.

Better by rest, lying on painful side, pressure, cold things.

Rheumatic pain 

Swelling of joints

Dropsical effusion into synovial and serous membrane.

Knee stiff and painful.

Hot swelling of feet.

Joint red, swollen, hot with stitches and tearing.

Worse on movement.

Constant motion of left arm and leg.

The selection of homoeopathic remedies based on symptom similarities and doses according to the Susceptibility of patient.

Don't take homoeopathic medicine without any prescription / without any advise of physician.