{"id":1021,"date":"2016-10-06T01:58:39","date_gmt":"2016-10-06T01:58:39","guid":{"rendered":"http:\/\/doktermuslim.com\/?p=1021"},"modified":"2016-10-06T01:59:46","modified_gmt":"2016-10-06T01:59:46","slug":"reumatoid-artritis-kriteria-diagnosis-dan-tatalaksana-part-4-4","status":"publish","type":"post","link":"https:\/\/doktermuslim.com\/reumatoid-artritis-kriteria-diagnosis-dan-tatalaksana-part-4-4\/","title":{"rendered":"Reumatoid Artritis – Kriteria diagnosis dan Tatalaksana (Part 4 of 4)"},"content":{"rendered":"

KRITERIA DIAGNOSIS<\/u><\/strong><\/h3>\n

Dalam menegakkan diagnosis reumathoid artritis, terdapat klasifikasi menurut American Collage of Reumathology, diantaranya :<\/p>\n

1. Guideline :<\/strong> untuk klasifikasi, diperlukan 4 dari 7 kriteria untuk menegakkan diagnosis reumarhoid artritis. penderita dengan 2 atau lebih diagnosis klinis tidak dapat menyingkirkan diagnosis Reumathoid artritis. Kriteria haris berlangsung minimal 6 bulan. Kriteria b-e harus diobservasi oleh dokter.<\/p>\n

2. Kriteria :<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n
a.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Kaku sendi : kaku sendi pada area dan sekitar sendi berlangsung 1 jam sebelum perbaikan yang maksimal.<\/td>\n<\/tr>\n
b.\u00a0\u00a0\u00a0\u00a0\u00a0 Artritis pada 3 atau lebih sendi. Minimal 3 sendi yang diobservasi oleh dokter, ditemukan bengkak dan efusi sendi. Kemungkinan sendi yang terkena adalah sendi interphalangeal proksimal, metakarpophaangeal, pergelangan tangan, siku, lutut, pergelangan kaki, sendi metatarsophalangeal dextra dan sinistra.<\/td>\n<\/tr>\n
c.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Artritis sendi tangan : artritis pada pergelangan tangan metakarpophalangeal dan interphalang.<\/td>\n<\/tr>\n
d.\u00a0\u00a0\u00a0\u00a0\u00a0 Artritis simetris : keterlibatan yang simultan dari area sendi yang sama dari kedua sisi tubuh.<\/td>\n<\/tr>\n
e.\u00a0\u00a0\u00a0\u00a0\u00a0 Nodul reumathoid : nodul subcutan pada penonjolan tulang, permukaan ekstensor, daerah juxtaartikular yang diobservasi oleh dokter.<\/td>\n<\/tr>\n
f.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Faktor reumatoid serum positif<\/td>\n<\/tr>\n
g.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Perubahan radiologis : ditemukan erosi dan dekalsifikasi tulang atau sendi.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\n

TATALAKSANA<\/u><\/strong><\/h3>\n

Dalam terapi atau tatalaksana reumatoid artritis, dapat digunakan pengobatan farmakologis hingga pembedahan. Tujuan dari terapi adalah : mengurangi nyeri, menurunkan inflamasi, melindungi struktur sendi, memelihara fungsi dan mengontrol keterlibatan sistemik.<\/p>\n

a. Terapi medikamentosa<\/u><\/strong><\/h4>\n
    \n
  1. Diberikan DMARDS (disease modifiying Antireumathoid Drugs)<\/strong> : obat untuk mengubah perjalanan klinis dari reumathoid artritis. Efek DMARDS tidaklangsung tetapi memerlukan waktu beberapa minggu sampai bulan. Sediannya : methotreksat 7,5-25 mg setiap minggu.<\/li>\n
  2. Berikan steroid<\/strong> : prednisondosis rendah kurang dari 7,5 mg\/dl. Dapat mengendalikan gejala klinis dan mengurangi progresi terjadinya erosi sendi.<\/li>\n
  3. Imunisupresan<\/strong> : azatrioprine, leflunomide, cyclosporine, cyclophosphamid.<\/li>\n
  4. Agen biologis seperti<\/strong> : anti TNF (etanercept, infliximab, adalimumab), anti IL-1 (anakinra), anti CD20 (Rituximab).<\/li>\n<\/ol>\n

    b. Terapi pembedahan<\/u><\/strong><\/h4>\n

    Pembedahan dilakukan apabila terjadi kerusakan sendi yang berat. Pembedahan yang dapat dilakukan adalah arthroplasty dan total joint replacement dapat dikerjakan pada sendi oleh dokter spesialis orthopedi. Hasil baik biasanya ditemukan pada sendi panggul, lutut dan bahu.<\/p>\n

    \n

    REFERENSI<\/u><\/strong><\/h3>\n

    Pile et al, 2008. Reumathoid Artritis in : problem solving in reumathology<\/em><\/strong>. Pp. 79-114<\/p>\n

    Fauci et al. 2011. Reumathoid artritis in : Harrisons Rheumathology<\/em><\/strong>. Eds. Fauci AS, Langford CA<\/p>\n

    Paramaiswari, A. 2002. Buku Ajar Ilmu Penyakit Dalam<\/em><\/strong>. Bagian ilmu penyakit dalam. FK UGM, Yogyakarta.<\/p>\n","protected":false},"excerpt":{"rendered":"

    KRITERIA DIAGNOSIS Dalam menegakkan diagnosis reumathoid artritis, terdapat klasifikasi menurut American Collage of Reumathology, diantaranya : 1. Guideline : untuk klasifikasi, diperlukan 4 dari 7 [Read more]<\/a><\/p>\n","protected":false},"author":1,"featured_media":1015,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[29,31],"tags":[211,210,209],"newstopic":[],"yoast_head":"\nReumatoid Artritis - Kriteria diagnosis dan Tatalaksana (Part 4 of 4) | Dokter Muslim<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/doktermuslim.com\/reumatoid-artritis-kriteria-diagnosis-dan-tatalaksana-part-4-4\/\" \/>\n<meta property=\"og:locale\" content=\"id_ID\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Reumatoid Artritis - Kriteria diagnosis dan Tatalaksana (Part 4 of 4) | Dokter Muslim\" \/>\n<meta property=\"og:description\" content=\"KRITERIA DIAGNOSIS Dalam menegakkan diagnosis reumathoid artritis, terdapat klasifikasi menurut American Collage of Reumathology, diantaranya : 1. Guideline : untuk klasifikasi, diperlukan 4 dari 7 [Read more]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/doktermuslim.com\/reumatoid-artritis-kriteria-diagnosis-dan-tatalaksana-part-4-4\/\" \/>\n<meta property=\"og:site_name\" content=\"Dokter Muslim\" \/>\n<meta property=\"article:author\" content=\"https:\/\/www.facebook.com\/doktermuslimcom\/\" \/>\n<meta property=\"article:published_time\" content=\"2016-10-06T01:58:39+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2016-10-06T01:59:46+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/doktermuslim.com\/wp-content\/uploads\/2016\/10\/reumatoid-artritis.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1300\" \/>\n\t<meta property=\"og:image:height\" content=\"750\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"dr. 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