{"id":10513,"date":"2024-08-15T09:32:45","date_gmt":"2024-08-15T09:32:45","guid":{"rendered":"https:\/\/langs.physio-pedia.com\/general-overview-of-rheumatoid-arthritis-for-rehabilitation-professionals-it\/"},"modified":"2024-08-16T09:36:20","modified_gmt":"2024-08-16T09:36:20","slug":"general-overview-of-rheumatoid-arthritis-for-rehabilitation-professionals-it","status":"publish","type":"page","link":"https:\/\/langs.physio-pedia.com\/it\/general-overview-of-rheumatoid-arthritis-for-rehabilitation-professionals-it\/","title":{"rendered":"Panoramica generale sull&#8217;artrite reumatoide per i professionisti della riabilitazione"},"content":{"rendered":"<div class=\"mw-parser-output\">\n<div class=\"editorbox\"><b>Redazione originale <\/b>&#8211; <a class=\"new\" title=\"Utente:Shala Cunningham (pagina inesistente)\" href=\"\/index.php?title=User:Shala_Cunningham&amp;action=edit&amp;redlink=1\">Shala Cunningham<\/a> <b>Contributori principali<\/b> &#8211; <a class=\"mw-userlink\" title=\"User:Jess Bell\" href=\"\/User:Jess_Bell\"><bdi>Jess Bell<\/bdi><\/a><\/div>\n<div id=\"toc\" class=\"toc\" role=\"navigation\" aria-labelledby=\"mw-toc-heading\"><input id=\"toctogglecheckbox\" class=\"toctogglecheckbox\" style=\"display: none;\" role=\"button\" type=\"checkbox\"><\/p>\n<div class=\"toctitle\" dir=\"ltr\" lang=\"en\">\n<h2 id=\"mw-toc-heading\">Contenuti<\/h2>\n<\/div>\n<ul>\n<li class=\"toclevel-1 tocsection-1\"><a href=\"#Introduction\"><span class=\"tocnumber\">1<\/span> <span class=\"toctext\">Introduzione<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-2\"><a href=\"#Epidemiology\"><span class=\"tocnumber\">2<\/span> <span class=\"toctext\">Epidemiologia<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-3\"><a href=\"#Risk_Factors\"><span class=\"tocnumber\">3<\/span> <span class=\"toctext\">Fattori di rischio<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-4\"><a href=\"#Clinical_Characteristics\"><span class=\"tocnumber\">4<\/span> <span class=\"toctext\">Caratteristiche cliniche<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-5\"><a href=\"#Typical_Joint_Deformities\"><span class=\"tocnumber\">5<\/span> <span class=\"toctext\">Deformit\u00e0 articolari tipiche<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-6\"><a href=\"#Pathophysiology\"><span class=\"tocnumber\">6<\/span> <span class=\"toctext\">Fisiopatologia<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-7\"><a href=\"#Basic_Overview_of_Rheumatoid_Arthritis_Pathophysiology\"><span class=\"tocnumber\">6.1<\/span> <span class=\"toctext\">Panoramica di base della fisiopatologia dell&#8217;artrite reumatoide<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-8\"><a href=\"#Diagnosis\"><span class=\"tocnumber\">7<\/span> <span class=\"toctext\">Diagnosi<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-9\"><a href=\"#Diagnostic_Tests\"><span class=\"tocnumber\">7.1<\/span> <span class=\"toctext\">Test diagnostici<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-10\"><a href=\"#Diagnostic_Criteria\"><span class=\"tocnumber\">7.2<\/span> <span class=\"toctext\">Criteri diagnostici<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-11\"><a href=\"#Treatment_for_Rheumatoid_Arthritis\"><span class=\"tocnumber\">8<\/span> <span class=\"toctext\">Trattamento dell&#8217;artrite reumatoide<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-12\"><a href=\"#Pharmacological_Management\"><span class=\"tocnumber\">8.1<\/span> <span class=\"toctext\">Gestione farmacologica<\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-13\"><a href=\"#Disease-Modifying_Antirheumatic_Drugs_(DMARDS)\"><span class=\"tocnumber\">8.1.1<\/span> <span class=\"toctext\">Farmaci antireumatici modificanti la malattia (DMARDS)<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-14\"><a href=\"#Other_Medications\"><span class=\"tocnumber\">8.1.2<\/span> <span class=\"toctext\">Altri farmaci<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-2 tocsection-15\"><a href=\"#Non-pharmacological_Management\"><span class=\"tocnumber\">8.2<\/span> <span class=\"toctext\">Gestione non farmacologica<\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-16\"><a href=\"#Exercise_\/_Physical_Activity\"><span class=\"tocnumber\">8.2.1<\/span> <span class=\"toctext\">Esercizio \/ Attivit\u00e0 fisica<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-17\"><a href=\"#Other_Non-pharmacological_Interventions\"><span class=\"tocnumber\">8.2.2<\/span> <span class=\"toctext\">Altri interventi non farmacologici<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-18\"><a href=\"#Additional_Resources\"><span class=\"tocnumber\">9<\/span> <span class=\"toctext\">Risorse aggiuntive<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-19\"><a href=\"#References\"><span class=\"tocnumber\">10<\/span> <span class=\"toctext\">Citazioni<\/span><\/a><\/li>\n<\/ul>\n<\/div>\n<h2><span id=\"Introduction\" class=\"mw-headline\">Introduzione<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Introduction\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=1\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Introduction\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=1\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<blockquote><p>L&#8217;artrite reumatoide (AR) \u00e8 una &#8220;malattia sistemica infiammatoria cronica autoimmune che solitamente si presenta con un&#8217;infiammazione articolare che provoca dolore, affaticamento e compromissione del funzionamento fisico e della produttivit\u00e0 lavorativa, tutti fattori che incidono negativamente sulla qualit\u00e0 della vita legata alla salute&#8221;.<sup id=\"cite_ref-1\" class=\"reference\"><a href=\"#cite_note-1\">(1)<\/a><\/sup><\/p><\/blockquote>\n<p>L&#8217;AR colpisce comunemente mani, polsi, spalle, gomiti, ginocchia, caviglie e piedi.<sup id=\"cite_ref-:0_2-0\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup> Trattandosi di una condizione sistemica, pu\u00f2 influenzare in modo significativo diversi sistemi corporei, tra cui quello cardiovascolare e respiratorio.<sup id=\"cite_ref-:0_2-1\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><sup id=\"cite_ref-:1_3-0\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><sup id=\"cite_ref-4\" class=\"reference\"><a href=\"#cite_note-4\">(4)<\/a><\/sup> Senza un trattamento adeguato, l&#8217;AR pu\u00f2 causare disabilit\u00e0 a lungo termine, dolore e morte prematura.<sup id=\"cite_ref-:2_5-0\" class=\"reference\"><a href=\"#cite_note-:2-5\">(5)<\/a><\/sup> <sup id=\"cite_ref-:3_6-0\" class=\"reference\"><a href=\"#cite_note-:3-6\">(6)<\/a><\/sup> Sebbene la gestione farmacologica sia il trattamento principale per l&#8217;AR,<sup id=\"cite_ref-:2_5-1\" class=\"reference\"><a href=\"#cite_note-:2-5\">(5)<\/a><\/sup> i professionisti della riabilitazione possono svolgere un ruolo nella gestione non farmacologica di questa patologia.<sup id=\"cite_ref-:0_2-2\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/p>\n<h2><span id=\"Epidemiology\" class=\"mw-headline\">Epidemiologia<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Epidemiology\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=2\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Epidemiology\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=2\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>L&#8217;AR colpisce circa l&#8217;1% della popolazione mondiale<sup id=\"cite_ref-:1_3-1\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup> e fino al 3% delle persone anziane.<sup id=\"cite_ref-:2_5-2\" class=\"reference\"><a href=\"#cite_note-:2-5\">(5)<\/a><\/sup> \u00c8 2-3 volte pi\u00f9 probabile che si manifesti nelle donne.<sup id=\"cite_ref-:3_6-1\" class=\"reference\"><a href=\"#cite_note-:3-6\">(6)<\/a><\/sup> Tuttavia, con il miglioramento della gestione medica, la gravit\u00e0, la mortalit\u00e0 e le comorbidit\u00e0 associate sembrano diminuire.<sup id=\"cite_ref-7\" class=\"reference\"><a href=\"#cite_note-7\">(7)<\/a><\/sup><\/p>\n<p>Il picco di et\u00e0 di insorgenza dell&#8217;AR tende ad essere nelle popolazioni pi\u00f9 giovani (circa 30-60 anni), anche se gli intervalli di et\u00e0 esatti riportati nella letteratura variano:<sup id=\"cite_ref-:4_8-0\" class=\"reference\"><a href=\"#cite_note-:4-8\">(8)<\/a><\/sup><sup id=\"cite_ref-9\" class=\"reference\"><a href=\"#cite_note-9\">(9)<\/a><\/sup><\/p>\n<ul>\n<li>la letteratura distingue l&#8217;AR con insorgenza in giovane et\u00e0 da quella con insorgenza in et\u00e0 pi\u00f9 avanzata (cio\u00e8 dopo i 60 anni)<sup id=\"cite_ref-:4_8-1\" class=\"reference\"><a href=\"#cite_note-:4-8\">(8)<\/a><\/sup><sup id=\"cite_ref-10\" class=\"reference\"><a href=\"#cite_note-10\">(10)<\/a><\/sup><\/li>\n<li>Slobodin<sup id=\"cite_ref-11\" class=\"reference\"><a href=\"#cite_note-11\">(11)<\/a><\/sup> osserva che il picco di et\u00e0 di insorgenza dell&#8217;AR \u00e8 aumentato\n<ul>\n<li>negli anni &#8217;30, il picco di et\u00e0 era negli individui di 30 anni<\/li>\n<li>nel 2010, il picco di et\u00e0 era negli individui di 50 o 60 anni<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><span id=\"Risk_Factors\" class=\"mw-headline\">Fattori di rischio<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Risk Factors\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=3\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Risk Factors\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=3\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>L&#8217;AR \u00e8 una malattia multifattoriale che \u00e8 stata collegata a diversi fattori genetici, ambientali e di altro tipo:<sup id=\"cite_ref-:1_3-2\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/p>\n<ul>\n<li><b>fattori genetici<\/b>: gli alleli HLA-DRB1 sono collegati a un maggior rischio di sviluppare l&#8217;AR<sup id=\"cite_ref-12\" class=\"reference\"><a href=\"#cite_note-12\">(12)<\/a><\/sup><\/li>\n<li><b>alcuni fattori ambientali<\/b> in individui geneticamente predisposti, come ad esempio:\n<ul>\n<li>fumo<\/li>\n<li>infezioni (ad esempio malattia parodontale,<sup id=\"cite_ref-:1_3-3\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup> virus di Epstein-Barr, superantigeni batterici, etc.<sup id=\"cite_ref-:5_13-0\" class=\"reference\"><a href=\"#cite_note-:5-13\">(13)<\/a><\/sup>)<\/li>\n<li>agenti alimentari<sup id=\"cite_ref-:1_3-4\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<li><b>fattori ormonali<\/b>:<sup id=\"cite_ref-:5_13-1\" class=\"reference\"><a href=\"#cite_note-:5-13\">(13)<\/a><\/sup>\n<ul>\n<li>si ritiene che gli effetti degli estrogeni sulla funzione immunitaria giochino un ruolo nella predominanza femminile dell&#8217;AR<\/li>\n<li>probabilmente sono coinvolti anche altri fattori legati al sesso<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><span id=\"Clinical_Characteristics\" class=\"mw-headline\">Caratteristiche cliniche<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Modifica la sezione: Caratteristiche cliniche\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=4\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Modifica la sezione: Caratteristiche cliniche\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=4\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>I sintomi comuni dell&#8217;AR articolare includono:<sup id=\"cite_ref-:0_2-3\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><sup id=\"cite_ref-:6_14-0\" class=\"reference\"><a href=\"#cite_note-:6-14\">(14)<\/a><\/sup><\/p>\n<ul>\n<li>dolori articolari simmetrici (polsi, dita (MCP), ginocchia, caviglie, piedi e colonna vertebrale superiore comunemente colpiti)<\/li>\n<li>rigidit\u00e0 mattutina che dura per pi\u00f9 di un&#8217;ora o rigidit\u00e0 dopo l&#8217;inattivit\u00e0<\/li>\n<li>le articolazioni possono essere percepite calde e dolenti dopo pi\u00f9 di un&#8217;ora di inattivit\u00e0<\/li>\n<li>perdita o limitazione del range di movimento<\/li>\n<li>deformit\u00e0<\/li>\n<\/ul>\n<h2><span id=\"Typical_Joint_Deformities\" class=\"mw-headline\">Deformit\u00e0 articolari tipiche<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Modifica la sezione: Deformit\u00e0 articolari tipiche\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=5\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Modifica la sezione: Deformit\u00e0 articolari tipiche\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=5\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p><b>Colonna cervicale<\/b>: la prevalenza dell&#8217;instabilit\u00e0 atlanto-assiale (AAI) nei soggetti con AR \u00e8 del 40-85%<sup id=\"cite_ref-15\" class=\"reference\"><a href=\"#cite_note-15\">(15)<\/a><\/sup><\/p>\n<ul>\n<li>ipermobilit\u00e0 tra C1 e C2<\/li>\n<li>lassit\u00e0 del legamento trasverso<\/li>\n<li>rischio di sublussazione<\/li>\n<li>possibile coinvolgimento neurologico<\/li>\n<\/ul>\n<p><b>Mano<\/b>:<sup id=\"cite_ref-:6_14-1\" class=\"reference\"><a href=\"#cite_note-:6-14\">(14)<\/a><\/sup><\/p>\n<ul>\n<li>deformit\u00e0 a collo di cigno<\/li>\n<li>deformit\u00e0 a boutonniere (deformit\u00e0 ad asola)<\/li>\n<li>deviazione ulnare<\/li>\n<li>flessione metacarpo-falangea del pollice con iperestensione interfalangea<\/li>\n<\/ul>\n<ul class=\"gallery mw-gallery-traditional\">\n<li class=\"gallerybox\" style=\"width: 285px;\">\n<div style=\"width: 285px;\">\n<div class=\"thumb\" style=\"width: 280px;\">\n<div style=\"margin: 66.5px auto;\"><a class=\"image\" title=\"Deformit\u00e0 del collo del cigno\" href=\"\/File:Swan_Neck_Deformity_-_Shutterstock_-_ID_1745730308_-_small.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/d\/d4\/Swan_Neck_Deformity_-_Shutterstock_-_ID_1745730308_-_small.jpg\/250px-Swan_Neck_Deformity_-_Shutterstock_-_ID_1745730308_-_small.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/d\/d4\/Swan_Neck_Deformity_-_Shutterstock_-_ID_1745730308_-_small.jpg\/375px-Swan_Neck_Deformity_-_Shutterstock_-_ID_1745730308_-_small.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/d\/d4\/Swan_Neck_Deformity_-_Shutterstock_-_ID_1745730308_-_small.jpg\/500px-Swan_Neck_Deformity_-_Shutterstock_-_ID_1745730308_-_small.jpg 2x\" alt=\"Deformit\u00e0 del collo del cigno\" width=\"250\" height=\"247\" data-file-width=\"2944\" data-file-height=\"2904\"><\/a><\/div>\n<\/div>\n<div class=\"gallerytext\">\n<p>Deformit\u00e0 a collo di cigno<\/p>\n<\/div>\n<\/div>\n<\/li>\n<li class=\"gallerybox\" style=\"width: 285px;\">\n<div style=\"width: 285px;\">\n<div class=\"thumb\" style=\"width: 280px;\">\n<div style=\"margin: 36.5px auto;\"><a class=\"image\" title=\"Deformit\u00e0 della boutonniere\" href=\"\/File:Boutonniere_Deformity_-_Shutterstock_-_1316292974_small.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/1\/12\/Boutonniere_Deformity_-_Shutterstock_-_1316292974_small.jpg\/250px-Boutonniere_Deformity_-_Shutterstock_-_1316292974_small.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/1\/12\/Boutonniere_Deformity_-_Shutterstock_-_1316292974_small.jpg\/375px-Boutonniere_Deformity_-_Shutterstock_-_1316292974_small.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/1\/12\/Boutonniere_Deformity_-_Shutterstock_-_1316292974_small.jpg\/500px-Boutonniere_Deformity_-_Shutterstock_-_1316292974_small.jpg 2x\" alt=\"Deformit\u00e0 della boutonniere\" width=\"250\" height=\"307\" data-file-width=\"2380\" data-file-height=\"2919\"><\/a><\/div>\n<\/div>\n<div class=\"gallerytext\">\n<p>Deformit\u00e0 a boutonniere (deformit\u00e0 ad asola)<\/p>\n<\/div>\n<\/div>\n<\/li>\n<\/ul>\n<p><b>Ginocchio<\/b>:<sup id=\"cite_ref-:6_14-2\" class=\"reference\"><a href=\"#cite_note-:6-14\">(14)<\/a><\/sup><\/p>\n<ul>\n<li>ginocchio valgo<\/li>\n<li>cisti di Baker<\/li>\n<\/ul>\n<p><b>Caviglia \/ piede<\/b>:<sup id=\"cite_ref-:6_14-3\" class=\"reference\"><a href=\"#cite_note-:6-14\">(14)<\/a><\/sup><\/p>\n<ul>\n<li>pronazione<\/li>\n<li>alluce valgo<\/li>\n<li>dita dei piedi ad artiglio<\/li>\n<\/ul>\n<ul class=\"gallery mw-gallery-traditional\">\n<li class=\"gallerybox\" style=\"width: 285px;\">\n<div style=\"width: 285px;\">\n<div class=\"thumb\" style=\"width: 280px;\">\n<div style=\"margin: 78px auto;\"><a class=\"image\" title=\"Cisti di Baker\" href=\"\/File:Baker%27s_Cyst_-_Shutterstock_-_ID_2163640049.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/d\/dc\/Baker%27s_Cyst_-_Shutterstock_-_ID_2163640049.jpg\/250px-Baker%27s_Cyst_-_Shutterstock_-_ID_2163640049.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/d\/dc\/Baker%27s_Cyst_-_Shutterstock_-_ID_2163640049.jpg\/375px-Baker%27s_Cyst_-_Shutterstock_-_ID_2163640049.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/d\/dc\/Baker%27s_Cyst_-_Shutterstock_-_ID_2163640049.jpg\/500px-Baker%27s_Cyst_-_Shutterstock_-_ID_2163640049.jpg 2x\" alt=\"Cisti di Baker\" width=\"250\" height=\"224\" data-file-width=\"2231\" data-file-height=\"1997\"><\/a><\/div>\n<\/div>\n<div class=\"gallerytext\">\n<p>Cisti di Baker<\/p>\n<\/div>\n<\/div>\n<\/li>\n<li class=\"gallerybox\" style=\"width: 285px;\">\n<div style=\"width: 285px;\">\n<div class=\"thumb\" style=\"width: 280px;\">\n<div style=\"margin: 104.5px auto;\"><a class=\"image\" title=\"Alluce valgo\" href=\"\/File:Hallux_Valgus_-_Shutterstock_-_ID_1169111032_small.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/f\/fc\/Hallux_Valgus_-_Shutterstock_-_ID_1169111032_small.jpg\/250px-Hallux_Valgus_-_Shutterstock_-_ID_1169111032_small.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/f\/fc\/Hallux_Valgus_-_Shutterstock_-_ID_1169111032_small.jpg\/375px-Hallux_Valgus_-_Shutterstock_-_ID_1169111032_small.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/f\/fc\/Hallux_Valgus_-_Shutterstock_-_ID_1169111032_small.jpg\/500px-Hallux_Valgus_-_Shutterstock_-_ID_1169111032_small.jpg 2x\" alt=\"Alluce valgo\" width=\"250\" height=\"171\" data-file-width=\"3840\" data-file-height=\"2625\"><\/a><\/div>\n<\/div>\n<div class=\"gallerytext\">\n<p>Alluce valgo<\/p>\n<\/div>\n<\/div>\n<\/li>\n<li class=\"gallerybox\" style=\"width: 285px;\">\n<div style=\"width: 285px;\">\n<div class=\"thumb\" style=\"width: 280px;\">\n<div style=\"margin: 75px auto;\"><a class=\"image\" title=\"Punta ad artiglio\" href=\"\/File:Claw_Toe_-_Adapted_Shutterstock_-_ID_1565224276_small.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/5\/50\/Claw_Toe_-_Adapted_Shutterstock_-_ID_1565224276_small.jpg\/250px-Claw_Toe_-_Adapted_Shutterstock_-_ID_1565224276_small.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/5\/50\/Claw_Toe_-_Adapted_Shutterstock_-_ID_1565224276_small.jpg\/375px-Claw_Toe_-_Adapted_Shutterstock_-_ID_1565224276_small.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/5\/50\/Claw_Toe_-_Adapted_Shutterstock_-_ID_1565224276_small.jpg\/500px-Claw_Toe_-_Adapted_Shutterstock_-_ID_1565224276_small.jpg 2x\" alt=\"Punta ad artiglio\" width=\"250\" height=\"230\" data-file-width=\"2616\" data-file-height=\"2408\"><\/a><\/div>\n<\/div>\n<div class=\"gallerytext\">\n<p>Dita dei piedi ad artiglio<\/p>\n<\/div>\n<\/div>\n<\/li>\n<\/ul>\n<p><b>Altri sintomi e manifestazioni extra-articolari<\/b>:<sup id=\"cite_ref-:0_2-4\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><sup id=\"cite_ref-:1_3-5\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><sup id=\"cite_ref-:6_14-4\" class=\"reference\"><a href=\"#cite_note-:6-14\">(14)<\/a><\/sup><sup id=\"cite_ref-:7_16-0\" class=\"reference\"><a href=\"#cite_note-:7-16\">(16)<\/a><\/sup><\/p>\n<ul>\n<li>problemi polmonari (ad esempio, pleurite, versamenti pleurici, fibrosi polmonare, malattia polmonare interstiziale e arterite<sup id=\"cite_ref-:1_3-6\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup>)<\/li>\n<li>problemi cardiaci (ad esempio aterosclerosi, rigidit\u00e0 arteriosa, arterite coronarica, insufficienza cardiaca congestizia, malattia valvolare e pericardite fibrinosa<sup id=\"cite_ref-:1_3-7\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup>)<\/li>\n<li>sindrome di Felty (cio\u00e8 basso numero di globuli bianchi, ingrossamento della milza e artrite reumatoide<sup id=\"cite_ref-17\" class=\"reference\"><a href=\"#cite_note-17\">(17)<\/a><\/sup>)<\/li>\n<li>secchezza degli occhi e della bocca (sindrome di Sj\u00f6gren)<\/li>\n<li>intorpidimento, formicolio o sensazione di bruciore alle mani e ai piedi<\/li>\n<li>difficolt\u00e0 nel sonno<\/li>\n<li>noduli reumatici\n<ul>\n<li>questi si verificano maggiormente nei soggetti con AR sieropositiva con malattia erosiva<sup id=\"cite_ref-:1_3-8\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup> (si veda la sezione Fisiopatologia per informazioni sull&#8217;AR sieropositiva \/ sieronegativa)<\/li>\n<\/ul>\n<\/li>\n<li>fatica<\/li>\n<li>riduzione delle funzioni cognitive<\/li>\n<li>sarcopenia<\/li>\n<li>osteoporosi<\/li>\n<li>vasculite (pu\u00f2 provocare &#8220;manifestazioni cutanee, complicazioni gastrointestinali, malattie cardiache e manifestazioni polmonari&#8221;<sup id=\"cite_ref-:1_3-9\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup>)<\/li>\n<\/ul>\n<h2><span id=\"Pathophysiology\" class=\"mw-headline\">Fisiopatologia<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Pathophysiology\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=6\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Pathophysiology\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=6\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Esistono due sottotipi principali di AR:<sup id=\"cite_ref-:7_16-1\" class=\"reference\"><a href=\"#cite_note-:7-16\">(16)<\/a><\/sup><sup id=\"cite_ref-:8_18-0\" class=\"reference\"><a href=\"#cite_note-:8-18\">(18)<\/a><\/sup><\/p>\n<ul>\n<li>AR sieropositiva:<sup id=\"cite_ref-:8_18-1\" class=\"reference\"><a href=\"#cite_note-:8-18\">(18)<\/a><\/sup>\n<ul>\n<li>sono presenti autoanticorpi, come il fattore reumatoide (RF) e gli anticorpi anti peptidi ciclici citrullinati (ACPA)<\/li>\n<li>gli autoanticorpi sono presenti nel 50% dei soggetti con AR precoce e fino all&#8217;80% dei soggetti con AR conclamata<\/li>\n<li>gli ACPA sono presenti in circa il 67% dei soggetti affetti da AR<sup id=\"cite_ref-:7_16-2\" class=\"reference\"><a href=\"#cite_note-:7-16\">(16)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>AR sieronegativa:<sup id=\"cite_ref-:8_18-2\" class=\"reference\"><a href=\"#cite_note-:8-18\">(18)<\/a><\/sup>\n<ul>\n<li>spesso considerata meno grave dell&#8217;AR sieropositiva, ma c&#8217;\u00e8 una certa controversia al riguardo<sup id=\"cite_ref-:17_19-0\" class=\"reference\"><a href=\"#cite_note-:17-19\">(19)<\/a><\/sup>\n<ul>\n<li>Volkov et al. notano che molti individui con AR RF-negativa o ACPA-negativa non sviluppano &#8220;una malattia cronica progressiva&#8221;<sup id=\"cite_ref-:8_18-3\" class=\"reference\"><a href=\"#cite_note-:8-18\">(18)<\/a><\/sup><\/li>\n<li>Carbonell-Bobadilla et al.<sup id=\"cite_ref-:17_19-1\" class=\"reference\"><a href=\"#cite_note-:17-19\">(19)<\/a><\/sup> notano che nell&#8217;AR sieronegativa potrebbero esserci meno danni alle articolazioni, ma un rischio cardiovascolare a lungo termine simile<\/li>\n<\/ul>\n<\/li>\n<li>potrebbero essere presenti altri tipi di autoanticorpi<sup id=\"cite_ref-:9_20-0\" class=\"reference\"><a href=\"#cite_note-:9-20\">(20)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3><span id=\"Basic_Overview_of_Rheumatoid_Arthritis_Pathophysiology\" class=\"mw-headline\">Panoramica di base sulla fisiopatologia dell&#8217;artrite reumatoide<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Modifica la sezione: Panoramica di base sulla fisiopatologia dell'artrite reumatoide\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=7\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Modifica la sezione: Panoramica di base sulla fisiopatologia dell'artrite reumatoide\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=7\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>La fisiopatologia dell&#8217;AR \u00e8 complessa. I punti seguenti descrivono la fisiopatologia dell&#8217;AR sieropositiva. Si noti che i pazienti possono avere percorsi patogenetici e lineages cellulari diversi:<sup id=\"cite_ref-:5_13-2\" class=\"reference\"><a href=\"#cite_note-:5-13\">(13)<\/a><\/sup><sup id=\"cite_ref-:7_16-3\" class=\"reference\"><a href=\"#cite_note-:7-16\">(16)<\/a><\/sup><sup id=\"cite_ref-:14_21-0\" class=\"reference\"><a href=\"#cite_note-:14-21\">(21)<\/a><\/sup><sup id=\"cite_ref-:15_22-0\" class=\"reference\"><a href=\"#cite_note-:15-22\">(22)<\/a><\/sup><\/p>\n<ul>\n<li>un individuo geneticamente predisposto \u00e8 esposto a un fattore ambientale scatenante (ad esempio il fumo o un&#8217;infezione) &#8211; questo pu\u00f2 causare un&#8217;immunit\u00e0 alterata<\/li>\n<li>l&#8217;immunit\u00e0 disordinata potrebbe portare alla citrullinazione di alcune proteine &#8211; la citrullinazione \u00e8 quando l&#8217;aminoacido arginina si converte in citrullina<sup id=\"cite_ref-23\" class=\"reference\"><a href=\"#cite_note-23\">(23)<\/a><\/sup><\/li>\n<li>le cellule di presentazione dell&#8217;antigene riconoscono queste proteine modificate come estranee e le trasportano ai linfonodi e ai tessuti mucosi e linfoidi, dove attivano le cellule T-helper CD4+<\/li>\n<li>questo stimola le cellule B a proliferare e a differenziarsi in plasmacellule<\/li>\n<li>queste plasmacellule producono autoanticorpi (ad esempio gli ACPA e il fattore reumatoide)\n<ul>\n<li>gli ACPA possono essere rilevati prima che si sviluppino i sintomi articolari nei soggetti affetti da AR<sup id=\"cite_ref-:7_16-4\" class=\"reference\"><a href=\"#cite_note-:7-16\">(16)<\/a><\/sup><\/li>\n<li>la produzione di ACPA indica una &#8220;rottura della tolleranza immunologica&#8221;<sup id=\"cite_ref-:7_16-5\" class=\"reference\"><a href=\"#cite_note-:7-16\">(16)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>gli autoanticorpi possono quindi migrare nella sinovia articolare<\/li>\n<\/ul>\n<ul>\n<li>il gonfiore simmetrico nelle piccole articolazioni \u00e8 il &#8220;riflesso esterno dell&#8217;infiammazione della membrana sinoviale in seguito all&#8217;attivazione immunitaria&#8221;<sup id=\"cite_ref-:7_16-6\" class=\"reference\"><a href=\"#cite_note-:7-16\">(16)<\/a><\/sup><\/li>\n<\/ul>\n<ul>\n<li>una volta entrati nella sinovia, gli autoanticorpi iniziano a produrre citochine proinfiammatorie (ad esempio interferone-gamma e interleuchine)<\/li>\n<li>questo provoca il rilascio di citochine da parte di macrofagi, monociti e fibroblasti sinoviali, come il fattore di necrosi tumorale alfa (TNF alfa), l&#8217;interleuchina 6 (IL-6) e l&#8217;IL-1<\/li>\n<li>i fibroblasti sinoviali poi iniziano a proliferare, aumentando l&#8217;infiammazione articolare (iperplasia sinoviale)<\/li>\n<li>le cellule sinoviali proliferanti producono un &#8220;panno&#8221;, ovvero una membrana sinoviale ispessita composta da tessuto di granulazione distruttivo<\/li>\n<li>questo panno causa l&#8217;erosione della cartilagine e dell&#8217;osso<\/li>\n<li>le cellule sinoviali attivate producono anche proteasi che rompono la cartilagine<\/li>\n<li>le citochine infiammatorie causano un aumento dell&#8217;attivit\u00e0 degli osteoclasti (cellule che demoliscono l&#8217;osso) &#8211; c&#8217;\u00e8 anche una diminuzione dell&#8217;attivit\u00e0 degli osteoblasti (cellule che riparano \/ formano nuovo osso)<\/li>\n<li>questo porta alla perdita di tessuto osseo articolare e all&#8217;osteoporosi<\/li>\n<li>gli ACPA e RF formano complessi immunitari che attivano il sistema del complemento (una parte importante del sistema immunitario innato<sup id=\"cite_ref-24\" class=\"reference\"><a href=\"#cite_note-24\">(24)<\/a><\/sup>), che porta all&#8217;infiammazione cronica<\/li>\n<li>l&#8217;angiogenesi (cio\u00e8 la formazione di nuovi capillari a partire da vasi gi\u00e0 esistenti<sup id=\"cite_ref-25\" class=\"reference\"><a href=\"#cite_note-25\">(25)<\/a><\/sup>), si verifica in concomitanza con l&#8217;infiammazione cronica &#8211; ci\u00f2 consente a un maggior numero di cellule infiammatorie di raggiungere le articolazioni<\/li>\n<li>questo produce ulteriori fattori pro-infiammatori, che esacerbano i processi gi\u00e0 esistenti<\/li>\n<li>con il progredire dell&#8217;AR, vengono colpite pi\u00f9 articolazioni su entrambi i lati del corpo<\/li>\n<li>le citochine infiammatorie si diffondono anche in altre parti del corpo, causando sintomi extra-articolari, come ad esempio\n<ul>\n<li>vasculite<\/li>\n<li>noduli reumatoidi<\/li>\n<li>decomposizione delle proteine nel muscolo scheletrico<\/li>\n<\/ul>\n<\/li>\n<li>L&#8217;AR pu\u00f2 andare e venire, con varie esacerbazioni (riacutizzazioni) e periodi di remissione<sup id=\"cite_ref-26\" class=\"reference\"><a href=\"#cite_note-26\">(26)<\/a><\/sup><\/li>\n<\/ul>\n<p>Questo complesso processo viene spiegato in dettaglio in <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5920070\/\" rel=\"nofollow\">Rheumatoid arthritis: pathological mechanisms and modern pharmacologic therapies<\/a><sup id=\"cite_ref-:7_16-7\" class=\"reference\"><a href=\"#cite_note-:7-16\">(16)<\/a><\/sup> e nei seguenti video:<\/p>\n<div class=\"row\">\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/e_NZk8nFSPA?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-:14_21-1\" class=\"reference\"><a href=\"#cite_note-:14-21\">(21)<\/a><\/sup><\/div>\n<\/div>\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/EB5zxdAQGzU?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-:15_22-1\" class=\"reference\"><a href=\"#cite_note-:15-22\">(22)<\/a><\/sup><\/div>\n<\/div>\n<\/div>\n<h2><span id=\"Diagnosis\" class=\"mw-headline\">Diagnosi<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Diagnosis\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=8\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Diagnosis\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=8\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<h3><span id=\"Diagnostic_Tests\" class=\"mw-headline\">Test diagnostici<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Diagnostic Tests\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=9\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Diagnostic Tests\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=9\">modifica sorgente<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>I seguenti esami di laboratorio aiutano nella diagnosi di AR <i>sieropositiva<\/i>:<sup id=\"cite_ref-:6_14-5\" class=\"reference\"><a href=\"#cite_note-:6-14\">(14)<\/a><\/sup><\/p>\n<ul>\n<li>fattore reumatoide\n<ul>\n<li>circa l&#8217;80% dei soggetti affetti da AR presenta il fattore reumatoide<\/li>\n<li>c&#8217;\u00e8 un tasso del 5% di falsi positivi<\/li>\n<\/ul>\n<\/li>\n<li>test degli anticorpi anti peptide ciclico citrullinato (anti-CCP)\n<ul>\n<li>la comparsa di ACPA \u00e8 spesso utilizzata per diagnosticare e predire l&#8217;AR<\/li>\n<li>ha una specificit\u00e0 elevata &gt;97%<sup id=\"cite_ref-:7_16-8\" class=\"reference\"><a href=\"#cite_note-:7-16\">(16)<\/a><\/sup><\/li>\n<li>i tassi di sensibilit\u00e0 variano nella letteratura, dal 50 al 95%<sup id=\"cite_ref-27\" class=\"reference\"><a href=\"#cite_note-27\">(27)<\/a><\/sup><sup id=\"cite_ref-28\" class=\"reference\"><a href=\"#cite_note-28\">(28)<\/a><\/sup><sup id=\"cite_ref-29\" class=\"reference\"><a href=\"#cite_note-29\">(29)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Altri test includono:<sup id=\"cite_ref-:6_14-6\" class=\"reference\"><a href=\"#cite_note-:6-14\">(14)<\/a><\/sup><\/p>\n<ul>\n<li>Proteina C-reattiva (CRP): marcatore infiammatorio generale<\/li>\n<li>velocit\u00e0 di sedimentazione degli eritrociti (VES)\n<ul>\n<li>attivit\u00e0 relativa del processo patologico<\/li>\n<li>misura non specifica dell&#8217;infiammazione<\/li>\n<\/ul>\n<\/li>\n<li>emocromo completo<\/li>\n<li>radiografie\n<ul>\n<li>non mostreranno un&#8217;insorgenza precoce dell&#8217;AR<sup id=\"cite_ref-:10_30-0\" class=\"reference\"><a href=\"#cite_note-:10-30\">(30)<\/a><\/sup><\/li>\n<li>nelle fasi successive, ai raggi X potrebbero essere evidenti:\n<ul>\n<li>superfici articolari irregolari<\/li>\n<li>spazio articolare ridotto<\/li>\n<li>allineamento articolare anormale<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>analisi del liquido sinoviale\n<ul>\n<li>aumento dei globuli bianchi<\/li>\n<li>aumento della collagenasi<\/li>\n<li>aumento dei detriti (proteine)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3><span id=\"Diagnostic_Criteria\" class=\"mw-headline\">Criteri diagnostici<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Diagnostic Criteria\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=10\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Diagnostic Criteria\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=10\">fonte di modifica<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>I <b>criteri di classificazione dell&#8217;American College of Rheumatology (ACR) del 1987 per l&#8217;AR<\/b> sono i seguenti:<sup id=\"cite_ref-:11_31-0\" class=\"reference\"><a href=\"#cite_note-:11-31\">(31)<\/a><\/sup><\/p>\n<ul>\n<li>rigidit\u00e0 mattutina all&#8217;interno e intorno alle articolazioni che dura almeno un&#8217;ora<\/li>\n<li>gonfiore dei tessuti molli di tre o pi\u00f9 aree articolari<\/li>\n<li>gonfiore delle articolazioni interfalangee prossimali, metacarpo-falangee o del polso<\/li>\n<li>gonfiore simmetrico<\/li>\n<li>noduli reumatoidi<\/li>\n<li>presenza del fattore reumatoide<\/li>\n<li>erosioni radiografiche e\/o osteopenia periarticolare nelle articolazioni della mano e\/o del polso<\/li>\n<\/ul>\n<p>I primi quattro criteri devono essere presenti da almeno sei settimane. In questo sistema, artrite reumatoide = avere quattro o pi\u00f9 dei criteri di cui sopra.<sup id=\"cite_ref-:11_31-1\" class=\"reference\"><a href=\"#cite_note-:11-31\">(31)<\/a><\/sup><\/p>\n<p>Sebbene questi criteri &#8220;siano ben accettati come punto di riferimento per la definizione della malattia&#8221;,<sup id=\"cite_ref-:10_30-1\" class=\"reference\"><a href=\"#cite_note-:10-30\">(30)<\/a><\/sup> presentano delle limitazioni perch\u00e9 sono stati concepiti per differenziare gli individui con AR conclamata da altre condizioni reumatologiche. Non aiutano quindi a identificare gli individui con AR precoce.<sup id=\"cite_ref-:10_30-2\" class=\"reference\"><a href=\"#cite_note-:10-30\">(30)<\/a><\/sup><\/p>\n<p>I <b>criteri diagnostici dell&#8217;ACR\/ EULAR (European League Against Rheumatism) del 2010 per l&#8217;AR<\/b> sono i seguenti:<sup id=\"cite_ref-:10_30-3\" class=\"reference\"><a href=\"#cite_note-:10-30\">(30)<\/a><\/sup><\/p>\n<ul>\n<li><i>coinvolgimento articolare<\/i>: 1 articolazione grande = 0; 2-10 articolazioni grandi = 1; 1-3 articolazioni piccole (con o senza coinvolgimento delle articolazioni grandi) = 2; 4-10 articolazioni piccole (con o senza coinvolgimento delle articolazioni grandi) = 3; &gt;10 articolazioni (almeno 1 articolazione piccola) = 5<\/li>\n<li><i>sierologia<\/i> (per la classificazione \u00e8 necessario almeno un risultato del test): fattore reumatoide negativo e ACPA negativo = 0; RF poco positivo o ACPA poco positivo = 2; RF molto positivo o ACPA molto positivo = 3<\/li>\n<li><i>reattanti di fase acuta<\/i> (per la classificazione \u00e8 necessario almeno un risultato del test): CRP normale e VES normale = 0; CRP anormale o VES anormale = 1<\/li>\n<li><i>durata dei sintomi<\/i>: &lt; 6 settimane = 0; 6 o pi\u00f9 settimane = 1<\/li>\n<\/ul>\n<p>\u00c8 necessario un punteggio pari o superiore a 6 perch\u00e9 un individuo venga classificato come affetto da AR.<sup id=\"cite_ref-:10_30-4\" class=\"reference\"><a href=\"#cite_note-:10-30\">(30)<\/a><\/sup><\/p>\n<p>Cliccate <a class=\"external text\" href=\"https:\/\/assets.contentstack.io\/v3\/assets\/bltee37abb6b278ab2c\/blt88256f51d5771046\/rheumatoid-arthritis-classification-criteria-excerpt-2010.pdf\" rel=\"nofollow\">qui<\/a> per vedere i criteri diagnostici dell&#8217;ACR\/ EULAR (European League Against Rheumatism) del 2010 in forma di tabella.<\/p>\n<h2><span id=\"Treatment_for_Rheumatoid_Arthritis\" class=\"mw-headline\">Trattamento dell&#8217;artrite reumatoide<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Modifica la sezione: Trattamento dell'artrite reumatoide\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=11\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Modifica la sezione: Trattamento dell'artrite reumatoide\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=11\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Negli ultimi decenni ci sono stati molti sviluppi nel trattamento dell&#8217;AR.<sup id=\"cite_ref-:0_2-5\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup> Sebbene la gestione principale sia quella farmacologica, anche diversi interventi non farmacologici svolgono un ruolo importante, tra cui l&#8217;educazione del paziente, l&#8217;esercizio fisico, la fisioterapia e la terapia occupazionale.<sup id=\"cite_ref-:12_32-0\" class=\"reference\"><a href=\"#cite_note-:12-32\">(32)<\/a><\/sup><\/p>\n<h3><span id=\"Pharmacological_Management\" class=\"mw-headline\">Gestione farmacologica<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Modifica la sezione: Gestione farmacologica\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=12\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Modifica la sezione: Gestione farmacologica\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=12\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>La gestione farmacologica mira a ridurre l&#8217;infiammazione articolare e a inibire la progressione della malattia.<sup id=\"cite_ref-:6_14-7\" class=\"reference\"><a href=\"#cite_note-:6-14\">(14)<\/a><\/sup><\/p>\n<h4><span id=\"Disease-Modifying_Antirheumatic_Drugs_.28DMARDS.29\"><\/span><span id=\"Disease-Modifying_Antirheumatic_Drugs_(DMARDS)\" class=\"mw-headline\">Farmaci antireumatici modificanti la malattia (DMARDS)<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Modifica la sezione: Farmaci antireumatici modificanti la malattia (DMARDS)\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=13\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Modifica la sezione: Farmaci antireumatici modificanti la malattia (DMARDS)\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=13\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<blockquote><p>&#8220;La diagnosi precoce e l&#8217;intervento tempestivo con un farmaco antireumatico modificante la malattia (DMARD) rimangono la pietra miliare del trattamento per controllare l&#8217;infiammazione, prevenire i danni alle articolazioni e agli organi e ridurre il rischio di morte.&#8221;<\/p><\/blockquote>\n<p>I DMARDS includono: 1) DMARD sintetici convenzionali (es. metotrexato), 2) DMARDs sintetici mirati (es. inibitori della Janus Kinase (JAK)) e 3) DMARD biologici (ad esempio, biologici anti-fattore di necrosi tumorale (TNF) o biologici non-TNF).<\/p>\n<ul>\n<li>il metotrexato a basso dosaggio \u00e8 il trattamento iniziale principale per l&#8217;AR<\/li>\n<li>il 25-40% dei pazienti sperimenter\u00e0 miglioramenti significativi con il solo metotrexate<\/li>\n<li>se i pazienti hanno risposte inadeguate, possono essere introdotti altri agenti (ad esempio un inibitore della JAK o un agente biologico)<sup id=\"cite_ref-:5_13-3\" class=\"reference\"><a href=\"#cite_note-:5-13\">(13)<\/a><\/sup><\/li>\n<\/ul>\n<p>Il seguente articolo fornisce una discussione dettagliata sui DMARD per l&#8217;AR: <a class=\"external text\" href=\"https:\/\/www.mdpi.com\/2077-0383\/8\/7\/938\" rel=\"nofollow\">Current therapeutic options in the treatment of rheumatoid arthritis<\/a>.<sup id=\"cite_ref-:12_32-1\" class=\"reference\"><a href=\"#cite_note-:12-32\">(32)<\/a><\/sup> I seguenti video opzionali forniscono un semplice riepilogo dei DMARD per l&#8217;AR:<\/p>\n<div class=\"row\">\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/2kDbztlKXKM?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-33\" class=\"reference\"><a href=\"#cite_note-33\">(33)<\/a><\/sup><\/div>\n<\/div>\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/YSOhxIJCV-o?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-34\" class=\"reference\"><a href=\"#cite_note-34\">(34)<\/a><\/sup><\/div>\n<\/div>\n<\/div>\n<h4><span id=\"Other_Medications\" class=\"mw-headline\">Altri farmaci<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Modifica la sezione: Altri farmaci\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=14\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Modifica la sezione: Altri farmaci\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=14\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>Farmaci antinfiammatori non steroidei (FANS): ad esempio, ibuprofene, naprossene<sup id=\"cite_ref-:6_14-8\" class=\"reference\"><a href=\"#cite_note-:6-14\">(14)<\/a><\/sup><\/p>\n<ul>\n<li>diminuisce il dolore e migliora la funzione riducendo l&#8217;infiammazione acuta<\/li>\n<li>possono aiutare con i sintomi, ma non cambiano il decorso della malattia nell&#8217;AR<sup id=\"cite_ref-:13_35-0\" class=\"reference\"><a href=\"#cite_note-:13-35\">(35)<\/a><\/sup><\/li>\n<\/ul>\n<p>Corticosteroidi: ad esempio desametasone, cortisone<sup id=\"cite_ref-:6_14-9\" class=\"reference\"><a href=\"#cite_note-:6-14\">(14)<\/a><\/sup><\/p>\n<ul>\n<li>hanno una serie di effetti collaterali<\/li>\n<li>potrebbero aiutare a ridurre i sintomi, ma non cambiano il decorso della malattia nell&#8217;AR<sup id=\"cite_ref-:13_35-1\" class=\"reference\"><a href=\"#cite_note-:13-35\">(35)<\/a><\/sup><\/li>\n<\/ul>\n<h3><span id=\"Non-pharmacological_Management\" class=\"mw-headline\">Gestione non farmacologica<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Modifica la sezione: Gestione non farmacologica\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=15\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Modifica la sezione: Gestione non farmacologica\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=15\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<blockquote><p>&#8220;Nonostante la disponibilit\u00e0 di farmaci efficaci, esiste una percentuale sostanziale di pazienti con attivit\u00e0 patologica persistente o ricorrente, con o senza danni articolari. Inoltre, l&#8217;evidenza di un aumento del rischio cardiovascolare nei pazienti affetti da malattie articolari infiammatorie \u00e8 in aumento. Di conseguenza, molti pazienti hanno bisogno di un trattamento aggiuntivo non farmacologico, tra cui la fisioterapia&#8221;.<sup id=\"cite_ref-:0_2-6\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/p><\/blockquote>\n<p>Sebbene la riabilitazione non possa influenzare il processo patologico dell&#8217;AR, pu\u00f2 aiutare la funzione!<\/p>\n<p>NIZZA<sup id=\"cite_ref-36\" class=\"reference\"><a href=\"#cite_note-36\">(36)<\/a><\/sup> raccomanda che le persone affette da AR ricevano il contributo di vari membri del team di riabilitazione, tra cui fisioterapia, terapia occupazionale, podologia e psicologia.<\/p>\n<h4><span id=\"Exercise_.2F_Physical_Activity\"><\/span><span id=\"Exercise_\/_Physical_Activity\" class=\"mw-headline\">Esercizio \/ Attivit\u00e0 fisica<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Modifica la sezione: Esercizio fisico \/ Attivit\u00e0 fisica\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=16\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Modifica la sezione: Esercizio fisico \/ Attivit\u00e0 fisica\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=16\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>\u00c8 dimostrato che l&#8217;aumento dei livelli di attivit\u00e0 fisica \/ dell&#8217;esercizio fisico pu\u00f2 aiutare con i sintomi e ridurre l&#8217;impatto delle manifestazioni sistemiche dell&#8217;AR.<sup id=\"cite_ref-37\" class=\"reference\"><a href=\"#cite_note-37\">(37)<\/a><\/sup> Tuttavia, in generale, le persone affette da malattie reumatiche e muscoloscheletriche (RMD) sono meno attive rispetto ai controlli sani,<sup id=\"cite_ref-38\" class=\"reference\"><a href=\"#cite_note-38\">(38)<\/a><\/sup> svolgendo meno attivit\u00e0 fisica di quella raccomandata dalle linee guida internazionali (soprattutto coloro che hanno &lt;55 anni).<sup id=\"cite_ref-39\" class=\"reference\"><a href=\"#cite_note-39\">(39)<\/a><\/sup><\/p>\n<p>Il seguente video opzionale vi aiuter\u00e0 a saperne di pi\u00f9 sull&#8217;esercizio fisico per l&#8217;artrite reumatoide. I punti chiave del video sono:<sup id=\"cite_ref-:16_40-0\" class=\"reference\"><a href=\"#cite_note-:16-40\">(40)<\/a><\/sup><\/p>\n<ul>\n<li>tutti i tipi di esercizio producono benefici simili, quindi bisogna considerare le preferenze del proprio paziente<\/li>\n<li>l&#8217;esercizio deve essere personalizzato in base alle esigenze del paziente (ad esempio, tempo disponibile, interessi, accesso alle attrezzature, funzione, etc.)<\/li>\n<li>esaminare la funzione attuale e confrontarla con la funzione richiesta dal paziente<\/li>\n<li>considerare i livelli generali di attivit\u00e0 fisica insieme ai piani di esercizio<\/li>\n<li>includere le componenti di forza, resistenza e cardiovascolari in un piano di esercizio<\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 308px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 300px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/QdtXacpfBg8?\" width=\"300\" height=\"169\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-:16_40-1\" class=\"reference\"><a href=\"#cite_note-:16-40\">(40)<\/a><\/sup><\/p>\n<p>Peter et al.<sup id=\"cite_ref-:0_2-7\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup> hanno redatto una linea guida per la pratica clinica che descrive nel dettaglio la valutazione e la gestione fisioterapica dei soggetti affetti da AR, disponibile qui: <a class=\"external text\" href=\"https:\/\/academic.oup.com\/ptj\/article\/101\/8\/pzab127\/6277051?login=false\" rel=\"nofollow\">Clinical practice guideline for physical therapist management of people with rheumatoid arthritis<\/a>.<\/p>\n<p>Il programma SARAH (Strengthening And Stretching for Rheumatoid Arthritis of the Hand) \u00e8 considerato un trattamento aggiuntivo clinicamente efficace ed economicamente vantaggioso per migliorare la funzione della mano nei soggetti affetti da AR.<sup id=\"cite_ref-41\" class=\"reference\"><a href=\"#cite_note-41\">(41)<\/a><\/sup><sup id=\"cite_ref-42\" class=\"reference\"><a href=\"#cite_note-42\">(42)<\/a><\/sup> Maggiori informazioni su questo programma sono disponibili <a class=\"external text\" href=\"https:\/\/www.ndorms.ox.ac.uk\/rrio\/sarah-implementation\" rel=\"nofollow\">qui<\/a> e nel seguente video:<\/p>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 308px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 300px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/q1pNhMkJHhg?\" width=\"300\" height=\"169\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-43\" class=\"reference\"><a href=\"#cite_note-43\">(43)<\/a><\/sup><\/p>\n<h4><span id=\"Other_Non-pharmacological_Interventions\" class=\"mw-headline\">Altri interventi non farmacologici<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Modifica la sezione: Altri interventi non farmacologici\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=17\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Modifica la sezione: Altri interventi non farmacologici\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=17\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<ul>\n<li><b>Educazione del paziente<\/b> (rilevante in tutte le fasi del decorso della malattia)<sup id=\"cite_ref-44\" class=\"reference\"><a href=\"#cite_note-44\">(44)<\/a><\/sup> <sup id=\"cite_ref-:0_2-8\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><sup id=\"cite_ref-:6_14-10\" class=\"reference\"><a href=\"#cite_note-:6-14\">(14)<\/a><\/sup>\n<ul>\n<li>includere informazioni sull&#8217;AR e sull&#8217;importanza dell&#8217;esercizio fisico e di uno stile di vita sano<\/li>\n<li>strategie per ridurre la disabilit\u00e0 (nell&#8217;ambito del proprio specifico campo di applicazione pratica), ad esempio distribuendo il carico, utilizzando ausili<\/li>\n<li>sostenere il paziente affinch\u00e9 sia fisicamente attivo, ma distribuire l&#8217;energia nell&#8217;arco della giornata\/settimana in base alla stanchezza\/fatica<\/li>\n<li>riconoscere e affrontare gli ostacoli all&#8217;esercizio e all&#8217;attivit\u00e0 fisica\n<ul>\n<li>gli ostacoli possono includere la mancanza di conoscenze, la mancanza di supporto sociale, il dolore, la stanchezza, la paura che l&#8217;esercizio fisico danneggi le articolazioni, etc.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li><b>Protezione delle articolazioni<\/b><sup id=\"cite_ref-:6_14-11\" class=\"reference\"><a href=\"#cite_note-:6-14\">(14)<\/a><\/sup>\n<ul>\n<li>evitare posizioni di deformit\u00e0<\/li>\n<li>adottare le posizioni pi\u00f9 stabili<\/li>\n<li>evitare compiti ripetitivi<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li><b>Conservazione dell&#8217;energia<\/b>\n<ul>\n<li>considerare le complicazioni sistemiche, ad esempio la riduzione della funzione cardiovascolare<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li><b>Ausili<\/b><\/li>\n<\/ul>\n<h2><span id=\"Additional_Resources\" class=\"mw-headline\">Risorse aggiuntive<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Additional Resources\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=18\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Additional Resources\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=18\">modifica fonte<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<ul>\n<li>Peter WF, Swart NM, Meerhoff GA, Vliet Vlieland TPM. <a class=\"external text\" href=\"https:\/\/academic.oup.com\/ptj\/article\/101\/8\/pzab127\/6277051?login=false\" rel=\"nofollow\">Clinical practice guideline for physical therapist management of people with rheumatoid arthritis<\/a>. Phys Ther. 2021 Aug 1;101(8):pzab127.<\/li>\n<li>Majnik J, Cs\u00e1sz\u00e1r-Nagy N, B\u00f6cskei G, Bender T, Nagy G. <a class=\"external text\" href=\"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.991677\/full\" rel=\"nofollow\">Non-pharmacological treatment in difficult-to-treat rheumatoid arthritis<\/a>. Front Med (Lausanne). 2022 Aug 29;9:991677. doi: 10.3389\/fmed.2022.991677. PMID: 36106320; PMCID: PMC9465607.<\/li>\n<li>National Institute for Health and Care Excellence (NICE). <a class=\"external text\" href=\"https:\/\/www.nice.org.uk\/guidance\/ng100\/\" rel=\"nofollow\">Rheumatoid arthritis in adults: management: NICE guideline (NG100)<\/a>. 2018 (updated 2020).<\/li>\n<\/ul>\n<h2><span id=\"References\" class=\"mw-headline\">Citazioni<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: References\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;veaction=edit&amp;section=19\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: References\" href=\"\/index.php?title=General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals&amp;action=edit&amp;section=19\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"mw-references-wrap mw-references-columns\">\n<ol class=\"references\">\n<li id=\"cite_note-1\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-1\">\u2191<\/a><\/span> <span class=\"reference-text\">K\u00fc\u00e7\u00fckdeveci AA, Turan BK, Arienti C, Negrini S. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10170526\/\" rel=\"nofollow\">Overview of Cochrane Systematic Reviews of rehabilitation interventions for persons with rheumatoid arthritis: a mapping synthesis<\/a>. Eur J Phys Rehabil Med. 2023 Apr;59(2):259-69. <\/span><\/li>\n<li id=\"cite_note-:0-2\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:0_2-0\">2.0<\/a><\/sup> <sup><a href=\"#cite_ref-:0_2-1\">2.1<\/a><\/sup> <sup><a href=\"#cite_ref-:0_2-2\">2.2<\/a><\/sup> <sup><a href=\"#cite_ref-:0_2-3\">2.3<\/a><\/sup> <sup><a href=\"#cite_ref-:0_2-4\">2.4<\/a><\/sup> <sup><a href=\"#cite_ref-:0_2-5\">2.5<\/a><\/sup> <sup><a href=\"#cite_ref-:0_2-6\">2.6<\/a><\/sup> <sup><a href=\"#cite_ref-:0_2-7\">2.7<\/a><\/sup> <sup><a href=\"#cite_ref-:0_2-8\">2.8<\/a><\/sup><\/span> <span class=\"reference-text\">Peter WF, Swart NM, Meerhoff GA, Vliet Vlieland TPM. <a class=\"external text\" href=\"https:\/\/academic.oup.com\/ptj\/article\/101\/8\/pzab127\/6277051?login=false\" rel=\"nofollow\">Clinical practice guideline for physical therapist management of people with rheumatoid arthritis<\/a>. Phys Ther. 2021 Aug 1;101(8):pzab127. <\/span><\/li>\n<li id=\"cite_note-:1-3\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:1_3-0\">3.0<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-1\">3.1<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-2\">3.2<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-3\">3.3<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-4\">3.4<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-5\">3.5<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-6\">3.6<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-7\">3.7<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-8\">3.8<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-9\">3.9<\/a><\/sup><\/span> <span class=\"reference-text\">Radu AF, Bungau SG. <a class=\"external text\" href=\"https:\/\/www.mdpi.com\/2073-4409\/10\/11\/2857\" rel=\"nofollow\">Management of rheumatoid arthritis: an overview<\/a>. Cells. 2021 Oct 23;10(11):2857.<\/span><\/li>\n<li id=\"cite_note-4\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-4\">\u2191<\/a><\/span> <span class=\"reference-text\">Metsios GS, Kitas GD. Physical activity, exercise and rheumatoid arthritis: Effectiveness, mechanisms and implementation. Best Pract Res Clin Rheumatol. 2018 Oct;32(5):669-82. <\/span><\/li>\n<li id=\"cite_note-:2-5\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:2_5-0\">5.0<\/a><\/sup> <sup><a href=\"#cite_ref-:2_5-1\">5.1<\/a><\/sup> <sup><a href=\"#cite_ref-:2_5-2\">5.2<\/a><\/sup><\/span> <span class=\"reference-text\">Turk MA, Liu Y, Pope JE. Non-pharmacological interventions in the treatment of rheumatoid arthritis: A systematic review and meta-analysis. Autoimmun Rev. 2023 Jun;22(6):103323. <\/span><\/li>\n<li id=\"cite_note-:3-6\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:3_6-0\">6.0<\/a><\/sup> <sup><a href=\"#cite_ref-:3_6-1\">6.1<\/a><\/sup><\/span> <span class=\"reference-text\">GBD 2021 Rheumatoid Arthritis Collaborators. <a class=\"external text\" href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2665991323002114\" rel=\"nofollow\">Global, regional, and national burden of rheumatoid arthritis, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021<\/a>. Lancet Rheumatol. 2023 Sep 25;5(10):e594-e610. <\/span><\/li>\n<li id=\"cite_note-7\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-7\">\u2191<\/a><\/span> <span class=\"reference-text\">Finckh A, Gilbert B, Hodkinson B, Bae SC, Thomas R, Deane KD, et al. <a class=\"external text\" href=\"https:\/\/www.nature.com\/articles\/s41584-022-00827-y\" rel=\"nofollow\">Global epidemiology of rheumatoid arthritis<\/a>. Nat Rev Rheumatol. 2022 Oct;18(10):591-602. <\/span><\/li>\n<li id=\"cite_note-:4-8\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:4_8-0\">8.0<\/a><\/sup> <sup><a href=\"#cite_ref-:4_8-1\">8.1<\/a><\/sup><\/span> <span class=\"reference-text\">Yazici Y, Paget SA. Elderly-onset rheumatoid arthritis. Rheum Dis Clin North Am. 2000 Aug;26(3):517-26. <\/span> <\/li>\n<li id=\"cite_note-9\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-9\">\u2191<\/a><\/span> <span class=\"reference-text\">Bullock J, Rizvi SAA, Saleh AM, Ahmed SS, Do DP, Ansari RA, Ahmed J. <a class=\"external text\" href=\"https:\/\/karger.com\/mpp\/article\/27\/6\/501\/204422\" rel=\"nofollow\">Rheumatoid arthritis: A brief overview of the treatment<\/a>. Med Princ Pract. 2018;27(6):501-7. <\/span><\/li>\n<li id=\"cite_note-10\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-10\">\u2191<\/a><\/span> <span class=\"reference-text\">Pavlov-Dolijanovic S, Bogojevic M, Nozica-Radulovic T, Radunovic G, Mujovic N. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10608066\/\" rel=\"nofollow\">Elderly-onset rheumatoid arthritis: characteristics and treatment options<\/a>. Medicina (Kaunas). 2023 Oct 23;59(10):1878. <\/span><\/li>\n<li id=\"cite_note-11\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-11\">\u2191<\/a><\/span> <span class=\"reference-text\">Slobodin G. Rheumatoid arthritis. In: Slobodin G, Shoenfeld Y, editors. Rheumatic Disease in Geriatrics. Springer, Cham, 2020. <\/span> <\/li>\n<li id=\"cite_note-12\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-12\">\u2191<\/a><\/span> <span class=\"reference-text\">Chauhan K, Jandu JS, Brent LH, et al. Rheumatoid Arthritis. (Updated 2023 May 25). In: StatPearls (Internet). Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: <a class=\"external free\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK441999\/\" rel=\"nofollow\">https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK441999\/<\/a><\/span><\/li>\n<li id=\"cite_note-:5-13\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:5_13-0\">13.0<\/a><\/sup> <sup><a href=\"#cite_ref-:5_13-1\">13.1<\/a><\/sup> <sup><a href=\"#cite_ref-:5_13-2\">13.2<\/a><\/sup> <sup><a href=\"#cite_ref-:5_13-3\">13.3<\/a><\/sup><\/span> <span class=\"reference-text\">Gravallese EM, Firestein GS. Rheumatoid arthritis &#8211; common origins, divergent mechanisms. N Engl J Med. 2023 Feb 9;388(6):529-42. <\/span><\/li>\n<li id=\"cite_note-:6-14\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:6_14-0\">14.00<\/a><\/sup> <sup><a href=\"#cite_ref-:6_14-1\">14.01<\/a><\/sup> <sup><a href=\"#cite_ref-:6_14-2\">14.02<\/a><\/sup> <sup><a href=\"#cite_ref-:6_14-3\">14.03<\/a><\/sup> <sup><a href=\"#cite_ref-:6_14-4\">14.04<\/a><\/sup> <sup><a href=\"#cite_ref-:6_14-5\">14.05<\/a><\/sup> <sup><a href=\"#cite_ref-:6_14-6\">14.06<\/a><\/sup> <sup><a href=\"#cite_ref-:6_14-7\">14.07<\/a><\/sup> <sup><a href=\"#cite_ref-:6_14-8\">14.08<\/a><\/sup> <sup><a href=\"#cite_ref-:6_14-9\">14.09<\/a><\/sup> <sup><a href=\"#cite_ref-:6_14-10\">14.10<\/a><\/sup> <sup><a href=\"#cite_ref-:6_14-11\">14.11<\/a><\/sup><\/span> <span class=\"reference-text\">Cunningham S. Rheumatoid Arthritis Course. Physiopedia Plus, 2024.<\/span><\/li>\n<li id=\"cite_note-15\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-15\">\u2191<\/a><\/span> <span class=\"reference-text\">Cunningham S. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4984819\/\" rel=\"nofollow\">Upper cervical instability associated with rheumatoid arthritis: a case report<\/a>. J Man Manip Ther. 2016 Jul;24(3):151-7.<\/span><\/li>\n<li id=\"cite_note-:7-16\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:7_16-0\">16.0<\/a><\/sup> <sup><a href=\"#cite_ref-:7_16-1\">16.1<\/a><\/sup> <sup><a href=\"#cite_ref-:7_16-2\">16.2<\/a><\/sup> <sup><a href=\"#cite_ref-:7_16-3\">16.3<\/a><\/sup> <sup><a href=\"#cite_ref-:7_16-4\">16.4<\/a><\/sup> <sup><a href=\"#cite_ref-:7_16-5\">16.5<\/a><\/sup> <sup><a href=\"#cite_ref-:7_16-6\">16.6<\/a><\/sup> <sup><a href=\"#cite_ref-:7_16-7\">16.7<\/a><\/sup> <sup><a href=\"#cite_ref-:7_16-8\">16.8<\/a><\/sup><\/span> <span class=\"reference-text\">Guo Q, Wang Y, Xu D, Nossent J, Pavlos NJ, Xu J. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5920070\/\" rel=\"nofollow\">Rheumatoid arthritis: pathological mechanisms and modern pharmacologic therapies<\/a>. Bone Res. 2018 Apr 27;6:15. <\/span><\/li>\n<li id=\"cite_note-17\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-17\">\u2191<\/a><\/span> <span class=\"reference-text\">Arthritis Society Canada. Felty&#8217;s syndrome. Available from: <a class=\"external free\" href=\"https:\/\/arthritis.ca\/about-arthritis\/arthritis-types-(a-z)\/types\/felty-s-syndrome\" rel=\"nofollow\">https:\/\/arthritis.ca\/about-arthritis\/arthritis-types-(a-z)\/types\/felty-s-syndrome<\/a> (last accessed 22 May 2024).<\/span><\/li>\n<li id=\"cite_note-:8-18\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:8_18-0\">18.0<\/a><\/sup> <sup><a href=\"#cite_ref-:8_18-1\">18.1<\/a><\/sup> <sup><a href=\"#cite_ref-:8_18-2\">18.2<\/a><\/sup> <sup><a href=\"#cite_ref-:8_18-3\">18.3<\/a><\/sup><\/span> <span class=\"reference-text\">Volkov M, van Schie KA, van der Woude D. <a class=\"external text\" href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/imr.12829\" rel=\"nofollow\">Autoantibodies and B cells: The ABC of rheumatoid arthritis pathophysiology<\/a>. Immunol Rev. 2020 Mar;294(1):148-63. <\/span><\/li>\n<li id=\"cite_note-:17-19\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:17_19-0\">19.0<\/a><\/sup> <sup><a href=\"#cite_ref-:17_19-1\">19.1<\/a><\/sup><\/span> <span class=\"reference-text\">Carbonell-Bobadilla N, Soto-Fajardo C, Amezcua-Guerra LM, Batres-Marroqu\u00edn AB, Vargas T, et al. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC9424641\/\" rel=\"nofollow\">Patients with seronegative rheumatoid arthritis have a different phenotype than seropositive patients: A clinical and ultrasound study<\/a>. Front Med (Lausanne). 2022 Aug 16;9:978351.<\/span><\/li>\n<li id=\"cite_note-:9-20\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-:9_20-0\">\u2191<\/a><\/span> <span class=\"reference-text\">NEJM Group. What Is Rheumatoid Arthritis? | NEJM. Available from: <a class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=e_NZk8nFSPA\" rel=\"nofollow\">https:\/\/www.youtube.com\/watch?v=e_NZk8nFSPA<\/a> (last accessed 23 May 2024).<\/span><\/li>\n<li id=\"cite_note-:14-21\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:14_21-0\">21.0<\/a><\/sup> <sup><a href=\"#cite_ref-:14_21-1\">21.1<\/a><\/sup><\/span> <span class=\"reference-text\">NEJM Group. What Is Rheumatoid Arthritis? | NEJM. Available from: <a class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=e_NZk8nFSPA\" rel=\"nofollow\">http:\/\/www.youtube.com\/watch?v=e_NZk8nFSPA<\/a> (last accessed 23\/05\/2025)<\/span><\/li>\n<li id=\"cite_note-:15-22\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:15_22-0\">22.0<\/a><\/sup> <sup><a href=\"#cite_ref-:15_22-1\">22.1<\/a><\/sup><\/span> <span class=\"reference-text\">Osmosis from Elsevier. Rheumatoid arthritis &#8211; causes, symptoms, diagnosis, treatment, pathology. Available from: <a class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=EB5zxdAQGzU\" rel=\"nofollow\">https:\/\/www.youtube.com\/watch?v=EB5zxdAQGzU<\/a> (last accessed 23\/05\/2024)<\/span><\/li>\n<li id=\"cite_note-23\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-23\">\u2191<\/a><\/span> <span class=\"reference-text\">Gazitt T, Lood C, Elkon KB. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5101001\/\" rel=\"nofollow\">Citrullination in rheumatoid arthritis-a process promoted by neutrophil lysis?<\/a> Rambam Maimonides Med J. 2016 Oct 31;7(4):e0027.<\/span> <\/li>\n<li id=\"cite_note-24\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-24\">\u2191<\/a><\/span> <span class=\"reference-text\">Holers VM, Banda NK. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5985368\/\" rel=\"nofollow\">Complement in the initiation and evolution of rheumatoid arthritis<\/a>. Front Immunol. 2018 May 28;9:1057. <\/span><\/li>\n<li id=\"cite_note-25\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-25\">\u2191<\/a><\/span> <span class=\"reference-text\">Elshabrawy HA, Chen Z, Volin MV, Ravella S, Virupannavar S, Shahrara S. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4879881\/\" rel=\"nofollow\">The pathogenic role of angiogenesis in rheumatoid arthritis<\/a>. Angiogenesis. 2015 Oct;18(4):433-48. <\/span><\/li>\n<li id=\"cite_note-26\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-26\">\u2191<\/a><\/span> <span class=\"reference-text\">Orange DE, Yao V, Sawicka K, Fak J, Frank MO, Parveen S, et al. <a class=\"external text\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32668112\/\" rel=\"nofollow\">RNA identification of PRIME cells predicting rheumatoid arthritis flares<\/a>. N Engl J Med. 2020 Jul 16;383(3):218-28.<\/span><\/li>\n<li id=\"cite_note-27\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-27\">\u2191<\/a><\/span> <span class=\"reference-text\">Melbourne Pathology. Anti-CCP Insight \u2013 March 2019. Available from: <a class=\"external free\" href=\"https:\/\/www.mps.com.au\/media\/6479\/mp_insight_anti-ccp_final-in-house-march-19.pdf\" rel=\"nofollow\">https:\/\/www.mps.com.au\/media\/6479\/mp_insight_anti-ccp_final-in-house-march-19.pdf<\/a> (last accessed 8 June 2024).<\/span><\/li>\n<li id=\"cite_note-28\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-28\">\u2191<\/a><\/span> <span class=\"reference-text\">Cho J, Pyo JY, Fadriquela A, Uh Y, Lee JH. Comparison of the analytical and clinical performances of four anti-cyclic citrullinated peptide antibody assays for diagnosing rheumatoid arthritis. Clin Rheumatol. 2021 Feb;40(2):565-573. <\/span><\/li>\n<li id=\"cite_note-29\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-29\">\u2191<\/a><\/span> <span class=\"reference-text\">Zhu JN, Nie LY, Lu XY, Wu HX. <a class=\"external text\" href=\"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/cclm-2019-0167\/html\" rel=\"nofollow\">Meta-analysis: compared with anti-CCP and rheumatoid factor, could anti-MCV be the next biomarker in the rheumatoid arthritis classification criteria?<\/a> Clin Chem Lab Med. 2019 Oct 25;57(11):1668-79.<\/span> <\/li>\n<li id=\"cite_note-:10-30\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:10_30-0\">30.0<\/a><\/sup> <sup><a href=\"#cite_ref-:10_30-1\">30.1<\/a><\/sup> <sup><a href=\"#cite_ref-:10_30-2\">30.2<\/a><\/sup> <sup><a href=\"#cite_ref-:10_30-3\">30.3<\/a><\/sup> <sup><a href=\"#cite_ref-:10_30-4\">30.4<\/a><\/sup><\/span> <span class=\"reference-text\">Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, et al. <a class=\"external text\" href=\"https:\/\/ard.bmj.com\/content\/69\/9\/1580.long\" rel=\"nofollow\">2010 rheumatoid arthritis classification criteria: an American College of Rheumatology\/European League Against Rheumatism collaborative initiative<\/a>. Arthritis Rheum. 2010 Sep;62(9):2569-81. <\/span><\/li>\n<li id=\"cite_note-:11-31\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:11_31-0\">31.0<\/a><\/sup> <sup><a href=\"#cite_ref-:11_31-1\">31.1<\/a><\/sup><\/span> <span class=\"reference-text\">Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988 Mar;31(3):315-24.<\/span><\/li>\n<li id=\"cite_note-:12-32\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:12_32-0\">32.0<\/a><\/sup> <sup><a href=\"#cite_ref-:12_32-1\">32.1<\/a><\/sup><\/span> <span class=\"reference-text\">K\u00f6hler BM, G\u00fcnther J, Kaudewitz D, Lorenz HM. <a class=\"external text\" href=\"https:\/\/www.mdpi.com\/2077-0383\/8\/7\/938\" rel=\"nofollow\">Current therapeutic options in the treatment of rheumatoid arthritis<\/a>. J Clin Med. 2019 Jun 28;8(7):938. <\/span><\/li>\n<li id=\"cite_note-33\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-33\">\u2191<\/a><\/span> <span class=\"reference-text\">Johns Hopkins Rheumatology. Rheumatoid Arthritis &#8211; Treatment | Johns Hopkins. Available from: <a class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=2kDbztlKXKM\" rel=\"nofollow\">https:\/\/www.youtube.com\/watch?v=2kDbztlKXKM<\/a> (last accessed 23\/05\/2024)<\/span><\/li>\n<li id=\"cite_note-34\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-34\">\u2191<\/a><\/span> <span class=\"reference-text\">Johns Hopkins Rheumatology. Treatment Options for Rheumatoid Arthritis | Johns Hopkins Rheumatology. Available from: <a class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=YSOhxIJCV-o\" rel=\"nofollow\">https:\/\/www.youtube.com\/watch?v=YSOhxIJCV-o<\/a> (last accessed 23\/05\/2024)<\/span><\/li>\n<li id=\"cite_note-:13-35\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:13_35-0\">35.0<\/a><\/sup> <sup><a href=\"#cite_ref-:13_35-1\">35.1<\/a><\/sup><\/span> <span class=\"reference-text\">Johns Hopkins Arthritis Center. Rheumatoid arthritis treatment. Available from: <a class=\"external free\" href=\"https:\/\/www.hopkinsarthritis.org\/arthritis-info\/rheumatoid-arthritis\/ra-treatment\/\" rel=\"nofollow\">https:\/\/www.hopkinsarthritis.org\/arthritis-info\/rheumatoid-arthritis\/ra-treatment\/<\/a> (last accessed 25 May 2024). <\/span><\/li>\n<li id=\"cite_note-36\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-36\">\u2191<\/a><\/span> <span class=\"reference-text\"><span class=\"reference-text\">National Institute for Health and Care Excellence (NICE), Rheumatoid arthritis in adults: management:<\/span><\/span>NICE guideline (NG100). 2018 (updated 2020). Available from: <a class=\"external free\" href=\"https:\/\/www.nice.org.uk\/guidance\/ng100\/\" rel=\"nofollow\">https:\/\/www.nice.org.uk\/guidance\/ng100\/<\/a> (accessed 24 May 2024).<\/li>\n<li id=\"cite_note-37\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-37\">\u2191<\/a><\/span> <span class=\"reference-text\">Metsios GS, Kitas GD. Physical activity, exercise and rheumatoid arthritis: Effectiveness, mechanisms and implementation. Best Pract Res Clin Rheumatol. 2018 Oct;32(5):669-82. <\/span><\/li>\n<li id=\"cite_note-38\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-38\">\u2191<\/a><\/span> <span class=\"reference-text\">Rausch Osthoff AK, Niedermann K, Braun J, Adams J, Brodin N, Dagfinrud H, et al. <a class=\"external text\" href=\"https:\/\/ard.bmj.com\/content\/77\/9\/1251.long\" rel=\"nofollow\">2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis<\/a>. Ann Rheum Dis. 2018 Sep;77(9):1251-60. <\/span><\/li>\n<li id=\"cite_note-39\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-39\">\u2191<\/a><\/span> <span class=\"reference-text\">Lange E, Kucharski D, Svedlund S, Svensson K, Bertholds G, Gjertsson I, Mannerkorpi K. <a class=\"external text\" href=\"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.23589\" rel=\"nofollow\">Effects of aerobic and resistance exercise in older adults with rheumatoid arthritis: A randomized controlled trial<\/a>. Arthritis Care Res (Hoboken). 2019 Jan;71(1):61-70. <\/span><\/li>\n<li id=\"cite_note-:16-40\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:16_40-0\">40.0<\/a><\/sup> <sup><a href=\"#cite_ref-:16_40-1\">40.1<\/a><\/sup><\/span> <span class=\"reference-text\">The Rheumatology Physio. Exercise and rheumatoid arthritis webinar. Available from: <a class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=QdtXacpfBg8\" rel=\"nofollow\">https:\/\/www.youtube.com\/watch?v=QdtXacpfBg8<\/a> (last accessed 25 May 2024).<\/span><\/li>\n<li id=\"cite_note-41\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-41\">\u2191<\/a><\/span> <span class=\"reference-text\">NDORMS. SARAH Implementation. Available from: <a class=\"external free\" href=\"https:\/\/www.ndorms.ox.ac.uk\/rrio\/sarah-implementation\" rel=\"nofollow\">https:\/\/www.ndorms.ox.ac.uk\/rrio\/sarah-implementation<\/a> (last accessed 24 May 2024).<\/span><\/li>\n<li id=\"cite_note-42\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-42\">\u2191<\/a><\/span> <span class=\"reference-text\">Lamb SE, Williamson EM, Heine PJ, Adams J, Dosanjh S, Dritsaki M, et al. <a class=\"external text\" href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(14)60998-3\/fulltext\" rel=\"nofollow\">Exercises to improve function of the rheumatoid hand (SARAH): a randomised controlled trial<\/a>. Lancet. 2015 Jan 31;385(9966):421-9. <\/span><\/li>\n<li id=\"cite_note-43\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-43\">\u2191<\/a><\/span> <span class=\"reference-text\">British Society for Rheumatology. Hand exercises for people with rheumatoid arthritis. Available from: <a class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=q1pNhMkJHhg\" rel=\"nofollow\">http:\/\/www.youtube.com\/watch?v=q1pNhMkJHhg<\/a> (last accessed 24\/05\/2024)<\/span><\/li>\n<li id=\"cite_note-44\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-44\">\u2191<\/a><\/span> <span class=\"reference-text\">Zangi HA, Ndosi M, Adams J, Andersen L, Bode C, Bostr\u00f6m C, et al. <a class=\"external text\" href=\"https:\/\/ard.bmj.com\/content\/74\/6\/954.long\" rel=\"nofollow\">EULAR recommendations for patient education for people with inflammatory arthritis<\/a>. Ann Rheum Dis. 2015 Jun;74(6):954-62. <\/span><\/li>\n<\/ol>\n<\/div>\n<p><!-- NewPP limit report Cached time: 20240806053134 Cache expiry: 0 Reduced expiry: true Complications: (show\u2010toc) CPU time usage: 0.209 seconds Real time usage: 0.227 seconds Preprocessor visited node count: 890\/1000000 Post\u2010expand include size: 262\/2097152 bytes Template argument size: 0\/2097152 bytes Highest expansion depth: 3\/100 Expensive parser function count: 0\/100 Unstrip recursion depth: 0\/20 Unstrip post\u2010expand size: 16083\/5000000 bytes --><br \/>\n<!-- Transclusion expansion time report (%,ms,calls,template) 100.00% 5.082 1 Special:Contributors\/General_Overview_of_Rheumatoid_Arthritis_for_Rehabilitation_Professionals 100.00% 5.082 1 -total --><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Redazione originale &#8211; Shala Cunningham Contributori principali &#8211; Jess Bell Contenuti 1 Introduzione 2 Epidemiologia 3 Fattori di rischio 4 Caratteristiche cliniche 5 Deformit\u00e0 articolari tipiche 6 Fisiopatologia 6.1 Panoramica di base della fisiopatologia dell&#8217;artrite reumatoide 7 Diagnosi 7.1 Test diagnostici 7.2 Criteri diagnostici 8 Trattamento dell&#8217;artrite reumatoide 8.1 Gestione farmacologica 8.1.1 Farmaci antireumatici modificanti [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-10513","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/pages\/10513","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/comments?post=10513"}],"version-history":[{"count":2,"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/pages\/10513\/revisions"}],"predecessor-version":[{"id":10526,"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/pages\/10513\/revisions\/10526"}],"wp:attachment":[{"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/media?parent=10513"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}