01 Jul 2011
By Thava Rani
Four years ago, he was struck by sudden pain in his leg in the middle of the night. The pain was so severe that he was unable to walk.
“It felt like I had a knife in my right knee,” said the otherwise healthy Mr Chiu Yeo Ding. The 88-year-old piano tuner was subsequently diagnosed with rheumatoid arthritis by doctors at Singapore General Hospital (SGH).
Rheumatoid arthritis is a chronic inflammatory disorder that affects the joints and, less frequently, the skin, eyes, lungs and other organs, according to Mr Chiu’s doctor, Dr Jon Yoong, Consultant Physician, Department of Rheumatology and Immunology, SGH.
“It is the most common autoimmune rheumatic disorder and it affects about one per cent of the population, or about 45,000 people. About 75 per cent of patients are women, but it affects all races, often beginning between the ages of 20 and 45 years,” he said.
In autoimmune disorders, the body’s immune system attacks its own tissues. It still isn’t known what causes rheumatoid arthritis, but some people seem more likely than others to develop the disease. It causes joint stiffness, pain, swelling and, sometimes, organ damage. Its severity varies among patients, and some patients may not realise they have the disease as the symptoms may be mild. They may feel persistent tiredness or mild joint stiffness.
“It is very important to diagnose rheumatoid arthritis as early as possible,” said Dr Yoong. Delayed treatment can lead to permanent damage of the organs and joints, and research has shown that prompt treatment improves the chances of the joints and organs remaining healthy.
To diagnose rheumatoid arthritis accurately, the doctor makes an evaluation that usually includes blood tests and x-rays. The patient is prescribed appropriate medication, and may also see a rheumatology nurse clinician, physiotherapist and occupational therapist for subsequent care.
Keeping a record of the patient’s condition between his three- to four-monthly consultations is important in managing his condition. At SGH, rheumatoid arthritis patients are encouraged to maintain a diary, either via a notebook or the smartphone web application recently launched by SGH.
“It helps to empower the patient and, at the same time, it gives us something objective to work with. In this way, we can get an accurate picture of the disease and make better clinical judgments,” said Dr Yoong.
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