Nursing Assessment, Management and Treatment of Autoimmune Diseases
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● Phase 2 : RA antibodies are produced. Pannus (thickened layers of granulation tissue) covers and invades cartilage, eventually destroying the joint capsule and bone. ● Phase 3 : This stage is characterized by arthralgia (joint stiffness), fibrous ankylosis, bone atrophy, and misalignment that causes visible deformities. ● Phase 4 : This stage is characterized by fibrous tissue calcification, which leads to bony ankylosis (joint fixation). Pain, restricted joint movement, soft-tissue contractures, and joint deformities are evident. Figure 7 shows the joint damage caused by RA.
antibodies. The person’s immune system does not recognize these antibodies as “self” and forms an antibody (the rheu- matoid factor) against the person’s own antibodies. The rheumatoid factor causes inflam - mation, which leads to cartilage damage (Rebar et al., 2019). Joint inflammation occurs in four stages (Rebar et al., 2019; Smith, 2021a): ● Phase 1 : Interaction occurs between genetic and environmental risk factors of RA. Initial inflammation in the joint capsule occurs in conjunction with swelling of the synovial tissue. This causes joint pain, swelling, and stiffness.
Figure 7. Rheumatoid Arthritis
Note . From National Library of Medicine U.S., 2013. Etiology The exact cause of RA is not known. However, experts propose that genetic, environmental, hormonal, immunologic, and infectious factors may contribute to its development (Smith, 2021a).
The following descriptions show how contributing factors may contribute to RA development (Smith, 2021a): ● Genetics : Genetic factors account for 50% of the risk of developing RA. Various genes are thought to contribute to the development of RA.
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