rheumatoid arthritisA type of arthritis
in which the jointsin the fingers, wrists,
toes, or elsewhere in the body become
painful, swollen, stiff, and, in severe
cases, deformed. Tissues outside the
joints, such as the heart, can also be
affected. Rheumatoid arthritis is an
autoimmune disorderthat usually starts
in early adulthood or middle age but
can also develop in children (see juve-
nile chronic arthritis) or elderly people.
Women are affected more often than
men. There are usually recurrent attacks.
Symptoms are mild fever and aches
followed by swelling, redness, pain, and
stiffness in the joints. Ligaments, ten-
dons, and musclesaround the joint may
also become inflamed. Raynaud’s phe-
nomenonmay occur in the fingers, and
swelling of the wrist may cause carpal
tunnel syndromeand tenosynovitis. Com-
plications caused by severe rheumatoid
arthritis include pericarditis, ulcerson
the hands and feet, pleural effusion, pul-
monary fibrosis, and Sjögren’s syndrome.
A diagnosis can be confirmed through
X-rays and blood tests. Treatments
include non-steroidal anti-inflammatory
drugs (NSAIDs); antirheumatic drugs,
such as gold, penicillamine, or sul-
fasalazine; and immunosuppressants,
such as azathioprineor corticosteroids.
Corticosteroid drugs may also be inject-
ed into the joints.
Physiotherapyis needed to prevent or
limit deformity or to help relieve symp-
toms and maintain mobility. People
who are disabled by arthritis can be
helped to cope with everyday tasks
through occupational therapy.
In severe cases, surgery may be per-
formed to replace damaged joints with
artificial ones (see arthroplasty). Most suf-
ferers must take drugs for life, but many
can achieve a near-normal level of activ-
ity with effective control of symptoms.
rheumatoid spondylitisSee ankylos-
ing spondylitis.
rheumatologyThe branch of medicine
concerned with the causes, develop-
ment, diagnosis, and treatment of
diseases that affect the joints, muscles,
and connective tissue.
rhinitisInflammation of the mucous
membranelining the nose, which maycause stuffiness, nasal discharge, and
sneezing. The most common causes are
the common cold (see cold, common),
which leads to viral rhinitis, and allergy,
which causes allergic rhinitis.
rhinitis, allergicInflammation of the
mucous membranelining the nose due
to allergyto pollen, dust, or other air-
borne substances. Also called hay fever,
it causes sneezing, a runny nose, and
nasal congestion. Antihistamine drugs
and topical corticosteroid drugs are
used to treat mild attacks. The drug
sodium cromoglicate, inhaled regularly
throughout the pollen season, may help
to prevent attacks. Long-term relief of
symptoms can sometimes follow desen-
sitization to a pollen allergen by a course
of injections (see hyposensitization).
rhinophymaBulbous deformity and red-
ness of the nosethat occurs almost
exclusively in elderly men. Rhinophyma
is a complication of severe rosacea. The
tissue of the nose thickens, small blood
vessels enlarge, and the sebaceous glands
become overactive, making the nose
excessively oily. An operation can restore
the nose to a satisfactory shape.
rhinoplastyAn operation that alters
the structure of the nose to improve its
appearance or to correct a deformity.
Incisions are made within the nose to
avoid visible scars. The septummay be
altered if breathing is blocked and the
cartilage and bone are then reshaped.
The nose is finally splinted in position
for about 10 days. Rhinoplasty usually
causes considerable bruising and
swelling, and the results may not be
clearly visible for weeks or months.
rhinorrhoeaThe discharge of watery
mucus from the nose, usually due to
rhinitis. Rarely, the discharge consists of
cerebrospinal fluid and is the result of a
head injury. (See also nasal discharge.)
rhythm methodSee contraception,
natural methods of.
ribAny of the flat, curved bones that
form a framework for the chest and a
protective cage around the heart, lungs,
and other underlying organs. There are
12 pairs of ribs, each joined at the back
of the ribcage to a vertebra. The upper 7
pairs, known as “true ribs”, link directly to
the sternumby flexible costal cartilage.RHEUMATOID ARTHRITIS RIBR