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Disease ARTHRITIS - RHEUMATOID
   
Quotation “Toxic drugs for chronic pain! Taking the bull by the horn is a good ideas as long as you and the bull agree on when you can let go”.
   
Definition A chronic systemic inflammatory disease with a predilection for joint involvement with soft tissue swelling or effusion, non-articular manifestations  and serum rheumatoid factor raised in up to 80%of patients.
   
Prognosis

Supportive therapy with good nutrition, exercises for ensuring muscle strength and mobility, anabolic steroids, protein and vitamin supplements.

Can remain active but should avoid physical stress during active phase.

Active physiatrist support

Reduction of joint stress

Treatment of associated depression and sleep disorders.

Treatment of sicca symptoms (in Sjorgen’s syndrome) with artificial tears and saliva
   
Advice to Patient

Importance of non-pharmacologic measures.

Understanding of possible toxic effects of drugs being consumed, and the absolute necessity for clinical and laboratory monitoring
   
Follow Up Rule out patient non-compliance, could be non-compliant due to side effects of drugs. Would call for exhibition of disease – remitting drugs, and later on to drugs of increasing potency.
   
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