Orthopedic Rheumatology

Rheumatoid arthritis is an autoimmune disease which causes inflammation of the synovium of the joints as well as the tendon sheaths. This is not a limited disease but a chronic, relapsing progressive systemic disease. The hand and wrist are the most common affected joints in the body.

Pathophysiology
In the early phase, there is a proliferation of inflammatory joint sense of synovium  and tendon sheaths. This causes swelling and pronounced pain. In the absence of treatment inflammatory tissue migrates into the articular cartilage and destroys these, resulting in the late phase to osteoarthritis and later to complete destruction of the joint. The ligaments and tendons are damaged, resulting in misaligned and stiffness of the joints and tendon rupture. In the final stage, there is a complete loss of function of the joint.

Therapy (Conservative treatment)
In early stages of the disease, treatment with anti-inflammatory drugs by a rheumatologist is the treatment of choice. Thus, the inflammatory process is interrupted or at least slowed down. Early diagnosis and adequate treatment by a rheumatologist positively affect the course of the disease.

Therapy (Surgical treatment)
In case of insufficient effect of drug therapy or already advanced disease, it is important not to delay the step to a surgical therapy.
Depending on the stage of the disease, there are different surgical methods. The decision is taken individually taking into account the affected joint, the present damage and the needs of the patient