from http://www.bbcnews.com
Rheumatoid arthritis (RA) (to be) _____ a chronic, inflammatory autoimmune disorder. RA (to cause) ________ the immune system to attack the joints. RA (to be) _____ a disabling and painful inflammatory condition. It can (to lead) ______ to substantial loss of mobility [mou’biliti] due to pain and joint destruction. The disease (to be) ______ also systemic. It often also (to affect) _______ many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and muscles. The symptoms (to be) ______ inflammation and soft-tissue swelling of many joints at the same time (polyarthritis), usually stiffness of all joints in the morning that (to last) ________ over 1 hour. Thus, the pain of rheumatoid arthritis (to be) ______ usually worse in the morning. Rheumatoid arthritis (to occur) ________ most frequently in the 20-40 age group, although can (to start) _________ at any age. Family history (to be) _____ an important risk factor. The disease (to affect) _________ females: males in a 3:1 ratio.
The American College of Rheumatology (to define) ___________ the following criteria for the diagnosis of rheumatoid arthritis.
- Morning stiffness of >1 hour.
- Arthritis and soft-tissue swelling of >3 of 14 joints/joint groups
- Arthritis of hand joints
- Symmetric arthritis
- Subcutaneous nodules in specific places
- Rheumatoid factor
- Radiological changes suggestive of joint erosion
When RA (to suspect) _________________ clinically, immunological studies (to require) ______________, such as rheumatoid factor. Also, several other blood tests are usually done to allow for other causes of arthritis. The erythrocyte sedimentation rate (ESR), C-reactive protein, full blood count, renal function, liver enzymes and immunological test (to perform) ________. Pharmacological treatment of RA can (to divide) ______________ into disease-modifying antirheumatic drugs (DMARDs), anti-inflammatory agents and analgesics. DMARDs (to found) _______________________ to produce durable remissions. These drugs (to delay) __________ or (to halt) ________ disease progression. Other therapies (to be) _______ weight loss, occupational therapy, physiotherapy, joint injections, and special tools to improve hard movements (e.g. special tin-openers). Severely affected joints may (to require) _________ joint replacement surgery, such as knee replacement.
