A couple of words about Rheumatoid Arthritis
Rheumatoid arthritis is a chronic inflammatory disease that attacks the joints and other parts of the body with serious consequences on health and quality of life of patients. If it is not treated timely and effectively, with the supervision of a rheumatologist, the inflammation can destroy the cartilage, the bones and the joints and all these can lead in damage of the affected joints, serious reduction of patient's mobility and functionality and even in serious disability.
It is the most common inflammatory disease of joints. It is estimated that it infects around one out of a hundred people worldwide, with a frequency three times greater in women than in men. In Europe it is estimated that more than 2,9 million people suffer from rheumatoid arthritis, whereas in Greece the number of patients is estimated to be around 70.000. The disease targets all age groups, but it mostly manifests in ages between 35 and 55 years of age. The exact causes of the disease still remain unknown. Recent studies have shown that it is linked to a combination of genetic, hormone, microbial and environmental factors, without being possible to determine the exact role of each one of them. Genetic predisposition seems to have a role, since there is a greater chance of the disease appearing in family members of at least one diagnosed occurrence of it.
Rheumatoid arthritis can manifest itself as either a chronic or an acute disease. In the first case, the patient manifests initially fatigue, stiffness and pain in joints, especially during daytime, after resting periods or after staying in immobility for some time. This pain then starts gradually aggravating in just a few weeks. In the second case, sudden and intense inflammation of multiple joints appears simultaneously, without any previous warning signs.
The signs of an inflamed joint consist of pain, swelling, increase of temperature as well as reduced mobility and functionality. Most frequently affects the joints of the fingers, toes, wrists, ankles and knees, usually symmetrically. A distinctive feature of the disease is the morning stiffness of the joints, that lasts for more than one hour after waking up or extended immobility.
Spondyloarthropathies or seronegative arthropathies constitute a group of diseases that have some common characteristics, meaning similar clinical manifestations and laboratory findings and are treated by rheumatologists as well. These diseases are Axial spondyloarthritis, Psoriatic arthritis, Reactive arthritis, Enteropathic arthritis (related to Crohn's disease and Ulcerative colitis) and the undifferentiated arthritis.
In Greece it is estimated that around 41.000 people suffer from Ankylosing spondylitis and Psoriatic arthritis.
 Encyclopedia of Autoimmune Diseases [Charalambos Moutsopoulos].
Psoriatic Arthritis is a disease of the immune system as well. It is characterized by inflammation in the joints (Arthritis) as well as in the skin (Psoriasis). It can cause pain and swelling in the joints and psoriatic plaques in the skin. In most patients, skin symptoms appear first, followed by arthritis' symptoms or they appear simultaneously. The percentage of patients with plaque psoriasis that can develop Psoriatic Arthritis in their lifetime is around 30%.
The disease affects men and women equally. It is diagnosed most frequnetly between 30 and 50 years of age, but can also be observed in younger or older people.
Psoriatic Arthritis is manifested with inflammatory signs such as pain, swelling, morning stiffness and tenderness when the joints are examined.
 Mease P. TNF-α therapy in psoriatic arthritis and psoriasis. Ann Rheum Dis. 2004;63 :755 -758
 Mease P, Goffe BS. Diagnosis and treatment of psoriatic arthritis. J Am Acad Derm.2005;52 :1-19.
Ankylosing Spondylitis is a chronic inflammatory disease that affects the spine, the joints between pelvis and spine as well as the thorax. It can also attack the hips, shoulders and knees, and less frequently the small peripheral joints. It usually affects young adults, people between the ages of 15 and 30, and it affects more men than women.
The cause of the disease is not identified. However, it seems that genetic and environmental factors contribute both to the development of the disease.
The most common symptom of Ankylosing Spondylitis is inflammatory back pain. This particular back pain due to inflammation has the following characteristics: worsens with rest, improves with exercise, is more intense during the second half of the night and can wake the patient up. It is accompanied by morning stiffness, meaning that the patient displays difficulty in movemants when they wake up. The pain expands from the pelvis and spin to the rear region of the thighs.
Chronic spinal cord inflammation (in vertebra, joints, tendons) can lead to the growth of new bone in these areas, resulting in permanent deformation of the sacroiliac joints in lumbar, thoracic, cervical spine and these changes can be seen in a radiography of the joint of the pelvis.
Axial Spondyloarthritis also includes another disease, Non-radiographically confirmed Axial Spondyloarthritis that can be expresses with inflammatory back pain (like Ankylosing Spondylitis), but the changes in x-ray are not visible. In this case, a magnetic resonance imaging test of the pelvis joints and spine may be required, to establish the diagnosis of this disease.