RHEUMATOID POLYARTHRITIS

What awaits you at Centrokinetic?

Centrokinetic welcomes patients, having a complete rheumatology department, a medical branch that deals with the diagnosis, treatment, and recovery of patients with non-surgical musculoskeletal disorders. These conditions are usually painful, acute, or, most often, chronic, preventing the proper functioning of the musculoskeletal system. They are generally called rheumatism or rheumatic and musculoskeletal diseases.

Most of the times, the patient's evaluation is complex, multidisciplinary, considering the systemic, generalized character of most rheumatological diseases, that is why Centrokinetic has experienced doctors:

• Rheumatologists: Dr. Alizzi Khalid and Dr. Oana Olteanu.
• Medical rehabilitation doctors: Dr. Tache Georgiana, Dr. Edis Mustafa, Dr. Matei Adina, Dr. Czego Renata.
• Orthopedic doctors: Dr. Andrei Bogdan, Dr. Vlad Gican and Dr. Crintea Alexandru
• Radiologists: Dr. Pantu Cosmin and Dr. Ghiea Sorin 
• Neurologists: Dr. Rotaru Bogdan, Dr. Simona Man and Dr. Simion Laurentiu
• Doctor of nutrition and metabolism diseases: Dr. Elian Viviana

What is rheumatoid arthritis?

Rheumatoid arthritis is an autoimmune disease that can cause joint pain and damage to the entire body. Joint injuries caused by this condition usually occur on both sides of the body. So, if it affects one joint in one arm or leg, the same joint in the other arm or leg will probably be affected as well. This is one way that doctors distinguish rheumatoid arthritis from other forms of arthritis, such as osteoarthritis.

Without proper treatment, chronic pain, disability, and severe impairment of normal life are unfortunate results of this disease. Rheumatoid arthritis causes joint damage in 80% to 85% of patients, and the lesions appear in the first 2 years of the disease. Left untreated, it increases the risk of mortality.

Rheumatoid arthritis is an autoimmune disease in which the body’s immune system (which normally protects its health by attacking foreign substances such as bacteria and viruses) erroneously attacks the joints. It creates inflammation that causes the tissue inside the joints (synovial tissue) to thicken, leading to swelling and pain in and around the joints. Synovial tissue produces a fluid that lubricates the joints and helps them move easily.

If we do not control the inflammation, it can affect the cartilage, the elastic tissue that covers the ends of the bones in a joint, and the bones themselves. Over time, there is a loss of cartilage, and the distance between the bones may become smaller. Joints can become loose, unstable, painful, and lose their mobility. Joint deformity can also occur. Joint damage cannot be reversed, and because it can occur early, doctors recommend early diagnosis and aggressive treatment to control rheumatoid arthritis.

Rheumatoid arthritis most commonly affects the joints of the hands, feet, wrists, elbows, knees, and ankles. The effect is usually symmetrical, meaning that if it affects the right hand, the left hand will most likely be affected too.

While inflammation of the tissue around the joints and inflammatory arthritis are features of rheumatoid arthritis, the disease can also cause inflammation and injury to other organs in the body. Because it can affect many organs in the body, rheumatoid arthritis is called systemic disease and is sometimes called rheumatoid disease. Rheumatoid arthritis is a classic rheumatic disease. Rheumatoid arthritis that begins in people under the age of 16 is called idiopathic juvenile polyarthritis.

The proximal interphalangeal and metacarpophalangeal joints of the hands, wrists and small joints of the legs, including the metatarsophalangeal joints, are most often involved. Shoulders, elbows, knees and ankles are also affected in many patients. Distal interphalangeal joints are devoid of this condition.

Diagnostic

The diagnosis of rheumatoid arthritis may require time and multiple laboratory tests to confirm the results of the clinical examination. Our doctors will use several tools to make a clear diagnosis.

Our medical team will come in addition to the investigations to establish a correct diagnosis, with imaging investigations (musculoskeletal ultrasound, joint MRI), functional tests (electromyography), and arthrocentesis. Discover the open MRI imaging center in our clinic. Centrokinetic has a state-of-the-art MRI machine, dedicated to musculoskeletal conditions, in the upper and lower limbs. The MRI machine is open so that people suffering from claustrophobia can do this investigation. The examination duration is, on average, 20 minutes.

Treatment

Treatment depends on the cause and diagnosis and differs depending on the type of arthritis. Rheumatoid arthritis has no exact cure, but doctors recommend that patients use aggressive treatments early in the diagnosis to reduce the severity of symptoms. There are a variety of treatment methods used to control symptoms and stop joint damage, including medications, surgery, daily routine, and lifestyle changes. It is necessary to communicate with a doctor or a rheumatologist in choosing effective treatments. They will make sure that the treatments are healthy and that the medications are prescribed correctly for the patient's situation or lifestyle.

Treating rheumatoid arthritis will not cure the disease, but certain treatments can significantly reduce pain and potentially permanent damage to the body. Depending on the severity of the symptoms, the goals of treatment will be to achieve "strict control" of polyarthritis, so the activity of the disease is kept constant at a low level. Keeping the disease in "strict control" can prevent long-term joint damage.

At Centrokinetic, our doctors can investigate, diagnose, and treat you to get the best results. They can also perform joint and periarticular injections with:

• Anti-inflammatory solutions or corticosteroids: are usually used for several types of musculoskeletal problems, such as tendinitis, tenosynovitis, bursitis, fasciitis, osteoarthritis, muscle injuries, ligament injuries. Corticosteroids are natural hormones made from cholesterol in the adrenal glands. In clinical practice, steroids are used for their powerful anti-inflammatory effects. Corticosteroids should not be confused with anabolic steroids, which are known to be used by athletes to increase muscle mass and strength. Corticosteroids used in resentment are injected all over the world, the administration doses are minimal, on average 0.4mg, and the side effects are similar in elderly patients, by temporarily increasing (2-3 days) blood pressure and blood sugar.
• Sterile viscoelastic solutions (hyaluronic acid): are performed mainly intraarticularly, both in the large joints (knee, shoulder, hip, ankle) and in the small ones (fist, elbow, metatarsophalangeal, or interphalangeal). The role of these infiltrations is multiple: protector of the articular cartilage through the viscous properties of the injection - the molecules of Hyaluronic Acid in the synovial fluid, act as a lubricant, protecting the articular surfaces from mechanical damage, by elastic properties - under the pressure generated by the joint load (bodyweight), hyaluronic acid in a synovial fluid acts as a shock absorber, protecting cartilage from compressive trauma, a nutrient for joint cartilage, synovial tissue protector: Hyaluronic acid is a protective barrier for the synovial membrane and masks the receptors for inflammation in the knee, reducing inflammation.
• Infiltrations with PRP (platelet hyperconcentrate): have been used since 1978 in the USA, in the treatment of musculoskeletal disorders, with extraordinary results. The infiltration lasts on average 40 minutes, is painless, and consists of collecting peripheral blood (from the vein) of the patient, on average between 60 and 180 ml, centrifugation 20-25 minutes to separate platelets from other blood cells, and injection into the same stage in the affected area. Centrokinetic offers patients treatments with the best PRP kits in the world, brought from the USA, from Arthrex and Magellan. The rationale for using this type of infiltration is to initiate and accelerate the natural process of tissue healing and regeneration by releasing platelet-derived growth factors directly into the affected tissue. According to current studies, soft tissue lesions and cartilage lesions are receptive to this treatment. Some of these include the following: tendinitis (epicondylitis, plantar tendonitis, Achilles, patellar, etc.), tendinosis, tendon ruptures, tendon degenerative lesions, muscle ruptures, cartilage lesions (arthrosis). The therapy also has a postoperative indication in meniscus suture, ligamentoplasty, sutures/tendon reinsertions (rotator cuff, Bankard, Achilles tendon, patellar tendon, quadrigeminal, etc.).
• Autologous growth factor therapy:  is a therapy used in Germany for 15 years, and consists of harvesting the body's growth factors, multiplying them by incubation, and reinjecting them into the affected area. The duration of the treatment is 3 hours, performing 3-5 procedures, at 1-week intervals. The major indications are chronic tendinitis (epicondylitis, plantar tendonitis, Achilles, patellar), and articular cartilage lesions (arthrosis). It also has excellent results in the treatment of joint and periarticular pain. Autologous growth factor therapy is a treatment with a cytokine-rich autologous serum (ACRS), derived from the patient's blood. To ensure high tolerability, this technology completely avoids the use of any artificial additives. This special serum, rich in autologous cytokines, can activate the body's ability to heal itself by producing positive interleukins and growth factors. These are crucial to intervene in the cascade of pain, causing it to stop and the subsequent onset of the healing process.

Centrokinetic clinic has a very experienced team, specialized in sports traumatology, accredited in: Tecar therapy, dynamic taping, massage, Graston technique, Kinesio Tape, ERGON, flossing band. Our team has attended numerous overspecialized courses with trainers from the country and abroad, being certified to perform therapies at the highest level.