We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Below we will list the departments and units that form part of Vall d’Hebron Hospital and the main diseases that we treat. We will also make recommendations based on advice backed up by scientific evidence that has been shown to be effective in guaranteeing well-being and quality of life.
We will guide you from your first visit to the centre, allowing you to find all the departments and make the most of our facilities. Whatever the reason for your visit, we will explain how to get about the hospital.
Rheumatoid arthritis is a chronic inflammatory disease that primarily affects the joints, although it can also compromise other organs. There is definitely a genetic component, but its cause is unknown.
It principally manifests as pain and inflammation in the joints (hands, feet, shoulders, knees, etc.) and morning stiffness. It can be accompanied by fever, general malaise, and/or fatigue.
Untreated rheumatoid arthritis can end up causing a deterioration and deformity of the affected joints, which can cause serious disabilities. However, the early diagnosis we often perform and the quantity of drugs we have available today mean that most patients with rheumatoid arthritis can lead a practically normal life. For rheumatoid arthritis to have a good clinical evolution, an early diagnosis is very important, starting treatment as soon as possible. This is because the first years during which the illness presents are key for improving the prognosis and evolution of these patients.
The most frequent symptoms are pain and inflammation in the joints. The joints that are most commonly affected are the knuckles of the hands, wrists, and feet, but the illness can also affect any other joint in the body (elbows, shoulders, hips, knees, etc.) and morning stiffness is typically associated with it. The joints of the spinal column are usually not affected, and when this happens it is in the neck area (cervical involvement).
Apart from the symptoms in the joints, rheumatoid arthritis can give rise to other symptoms or affect other organs.
In addition, patients with rheumatoid arthritis can present other associated illnesses more often than people without arthritis. They have a higher risk of suffering from osteoporosis (decalcification of the bones) and having cardiovascular problems like myocardial infarction or stroke. This is why in patients with rheumatoid arthritis, it's extremely important to control other factors that may aggravate their condition, such as high cholesterol, diabetes, high blood pressure, tobacco use, and obesity.
It can affect any person, of any race, anywhere in the world, but it affects more women than men (approximately three women for every man), and it usually appears between the ages of 40 and 60.
The cause of the disease is unknown. What we do know is that there are different components involved in the appearance of the disease:
Therefore, rheumatoid arthritis appears when a combination of the circumstances described above occurs at the same time. Alterations in the immune system can occur in genetically predisposed individuals and can combine with hormonal and environmental factors. It is not known exactly how this process happens.
Diagnosing the illness is done in a comprehensive way, considering the symptoms reported by the patient, the physical examination, the results of the analyses, and the X-rays. It is important to keep in mind that there is no blood test or other kind of test that can diagnose rheumatoid arthritis independently; a medical evaluation of the entire situation by a rheumatology specialist will always be required.
The symptoms described by the patient are usually the ones we've described in the "symptoms" section. The physical examination usually reveals pain, inflammation, and a limited range of movement in one or more joints, and this tends to be symmetrical.
On a blood analysis, elevated inflammatory markers are often observed, such as a high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level. Mild anaemia can also appear.
Rheumatoid factor (RF) can be tested for on a blood analysis, and 70-80% of patients with rheumatoid arthritis are positive for it. However, it's important to point out that up to 30% of healthy people without arthritis can also turn up positive, so being positive for this factor does not definitively tell us if someone has the disease.
Anti-cyclic citrullinated peptide (anti-CCP) antibody is a more specific biomarker for rheumatoid arthritis. This means that in a person with arthritis, if they are positive for this antibody, it practically confirms the diagnosis. However, if it turns up negative, the illness is not ruled out, since up to 40% of patients with rheumatoid arthritis are negative for this biomarker.
The fundamental basis for the treatment of this illness is using pharmaceuticals that we call disease-modifying drugs (DMDs). These drugs act on the cells and molecules that participate in the disease process and manage to change its natural course. We divide these into three groups: traditional, biological, and synthetic.
Besides the DMDs, another important part of treating arthritis is providing the patient with symptomatic relief. We round out treatment plans with pain relievers and conventional anti-inflammatory agents, to work in conjunction with DMDs during disease flare-ups or to provide relief while these agents take effect. They act quickly, but their effects are short-lived and disappear just hours after a dose is taken.
Within this group we also have corticosteroids, which are the most effective pharmaceuticals to quickly control joint inflammation. They can be administered orally or delivered directly to the inflamed joints as injections.
Unfortunately, there is no specific action to prevent the appearance of rheumatoid arthritis. Nevertheless, as we know tobacco use to be the only environmental factor that can contribute to the appearance of and a worse prognosis for arthritis, it is recommended that the entire population in general avoid this habit, but this is especially true for patients at risk for arthritis.
Sociedad Española de Reumatología: aprendiendo a convivir con la Artritis Reumatoide
American College of Rheumatology (ACR): la Artritis Reumatoide
American College of Rheumatology (ACR): web amb informació detallada dels tractaments més utilitzats en reumatologia
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