SYMPTOMS OF RHEUMATOID ARTHRITIS (RA): SKIN

People generally first notice skin nodules while dressing or bathing. They appear beneath the skin as small knots called rheumatoid nodules, and they occur in approximately one quarter of people with established RA. They are more likely to appear in people who have rheumatoid factor than in people who don’t have it.
Skin nodules often form close to joints, overlying areas that are susceptible to trauma or pressure such as tendons or bony protrusions like the elbows, knuckles, or Achilles tendon. They often come and go in a pattern that follows the pattern of arthritis.
Rheumatoid nodules are benign (harmless) lumps that should not be confused with enlarged lymph nodes or tumors (which may or may not be harmless). The nodules are only bothersome when they press against internal body structures, interfere with the motion of a joint or tendon, or become infected. Rheumatoid nodules are not painful unless they are positioned in an area that is frequently traumatized, such as the heel tendon, which is rubbed by the back of the shoe. Rheumatoid nodules rarely appear in places other than the skin. On occasion they do appear in the lungs, heart, eyes, and vocal cords, but even in these places rheumatoid nodules seldom produce symptoms.
Rheumatoid nodules themselves do not merit special treatment unless they cause pain, decrease function, or become infected. Anyone who has rheumatoid nodules, however, should be considered for treatment with drugs that can produce remission since the presence of nodules may indicate a more serious form of arthritis. Successful treatment with DMARDs can result in the resolution of nodules as well as improvement in arthritis. In a specific situation in which a particular nodule is causing structural problems, surgical removal is an option. Although removal of nodules for cosmetic reasons is generally discouraged, surgery is occasionally performed to improve appearance, too.
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SURGERY TO RELIEVE ARTHRITIC PAINS

We have just explained that surgical operations on organs or glands cannot solve the question of arthritis. But can a doctor “operate” on actual arthritic bones and relieve your pain? The answer is “Yes.”
After deformity has set in, there are a number of orthopaedic operations which are helpful. More surgery will undoubtedly be devised in the future. Meanwhile, some of the operations now being used successfully for deformed arthritics only are known as synovectomy, arthrodesis, arthroplasty, etc.
Operations can be performed to remove any flesh-like tabs clinging to joint linings. These are frequently found in osteo-arthritis and sometimes they impede joint mobility. Surgery can also cut away some bone-spurs or extraneous deposits of cartilage or bone called “joint mice.”
But before allowing your arthritis to reach the stage where surgical help is needed, wouldn’t it be far better to practise the dietary and oil regime in this book? Prevent deformity by sane eating habits, and escape the surgeon’s knife.
If a knee swells up to twice its normal size, and the trouble is a diseased lining, it is true that the joint membrane can be removed surgically. Joint linings will then regenerate, and your body will build new ones. At that time you may decide to straighten out your diet, to protect your “second set” of linings. Why not eat correctly now? You’ll save yourself a trip to the surgeon and a long convalescence.
One type of deformity is “fusion.” When a joint becomes fused, it is said to be ankylosed. An ankylosed joint is frequently free from pain. The operation known as arthrodesis is primarily designed to give the fused joint some degree of service … at least enable it to bear some weight. An arthoplasty operation will improve ball and socket joint mobility, by inserting a metal cup in your joint. Again, we say, however, stop your arthritic advancement by diet, before you need to undergo these major measures.
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ARTHRITIS: THYROID EXTRACTS HAVE SOME MERIT

Doctors treating arthritis next turned to compounds derived from thyroid extracts. We believe these preparations may do some good, because of the iodine value. Sixty per cent, of your body’s iodine is tied up in the thyroid gland. When you lack vigour, a basal metabolism test will generally reveal a sluggish thyroid. A good percentage of osteo- and rheumatoid arthritics have a sluggish thyroid gland.
Such a thyroid deficiency usually indicates a lack of body iodine. Symptoms of this deficiency include dry skin, brittle nails and slow pulse. Also you may notice coarser skin over the ankles, cheek bones, and back of the hands, or intermittent swelling about the eyes, cold and clammy legs or hands.
To correct these conditions, however, instead of taking a thyroid extract (a compound like potassium iodide) why not use simple cod-liver oil? The iodine in cod-liver oil can nourish an ailing thyroid —plus the entire arthritic body! The arthritic choosing cod-liver oil for its iodine can easily correct his many external symptoms of dryness. And, at the very same time, he will be lubricating the joints themselves.
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