What is Rheumatoid Arthritis (RA)
Rheumatoid arthritis is a long-term (chronic) disease that causes inflammation in your joints.
Rheumatoid Arthritis may start slowly. It usually affects the small joints of the hands and feet.
Usually, the same joints are affected on both sides of your body. Inflammation from Rheumatoid Arthritis can also affect other parts of your body, including your heart, eyes, or lungs.
Rheumatoid Arthritis is a chronic, systemic, inflammatory disorder of joints that is characterized by its pattern of joint involvement, and in the majority of cases, serum elevations of autoantibodies that include rheumatoid factor (RF) and antibodies to citrullinated protein/peptide antigens (ACPA).
The primary site of pathology is the synovium of the joints. The synovial tissues become inflamed and proliferate, forming pannus that invades bone, cartilage, and ligaments and leads to damage and deformities.
Extraarticular manifestations such as lung disease may accompany the joint disease, but arthritis represents the major manifestation.
Rheumatoid Arthritis is an autoimmune disease. That means that your body’s defense system (immune system) mistakenly attacks healthy body tissues.
There is no cure for Rheumatoid Arthritis, but medicines can help your symptoms and halt or slow down the progression of the disease.
5 Interesting Facts of Rheumatoid Arthritis
1. Rheumatoid arthritis (RA) is the most common chronic inflammatory arthritis.
2. Synovitis of the small joints of the hands (metacarpophalangeal joints [MCPs], proximal interphalangeal joints [PIPs]) and wrists is the classic initial pattern.
3. RA patients with extraarticular manifestations should be seropositive.
4. Early and aggressive therapy should target low disease activity for optimal outcomes.
5. RA patients have accelerated atherosclerosis warranting aggressive risk factor modification.
What are the causes?
The exact cause of Rheumatoid Arthritis is not known.
What increases the risk of Rheumatoid Arthritis?
This condition is more likely to develop in:
- People who have a family history of RA or other autoimmune diseases.
What are the symptoms of Rheumatoid Arthritis?
Symptoms of this condition vary from person to person. Symptoms usually start gradually. They are often worse in the morning. The first symptom may be morning stiffness that lasts longer than 30 minutes.
As Rheumatoid Arthritis progresses, symptoms may include:
- Pain, stiffness, swelling, warmth, and tenderness in joints on both sides of your body.
- Loss of energy.
- Loss of appetite.
- Weight loss.
- Low-grade fever.
- Dry eyes and dry mouth.
- Firm lumps (rheumatoid nodules) that grow beneath your skin in areas such as your forearm bones near your elbows and on your hands.
- Changes in the appearance of joints (deformity) and loss of joint function.
Symptoms of RA often come and go. Sometimes, symptoms get worse for a period of time. These are called flares.
How is Rheumatoid Arthritis diagnosed?
This condition is diagnosed based on your symptoms, medical history, and physical exam. You may have X-rays or MRI to check for the type of joint changes that are caused by RA. You may also have blood tests to look for:
- Proteins (antibodies) that your immune system may make if you have Rheumatoid Arthritis. They include rheumatoid factor (RF) and anti-CCP.
- When blood tests show these proteins, you are said to have “seropositive RA.”
- When blood tests do not show these proteins, you may have “seronegative RA.”
- Inflammation in your blood.
- A low number of red blood cells (anemia).
How is Rheumatoid Arthritis treated?
The goals of treatment are to relieve pain, reduce inflammation, and slow down or stop joint damage and disability. Treatment may include:
- Lifestyle changes. It is important to rest, eat a healthy diet, and exercise.
- Medicines. Your health care provider may adjust your medicines
every 3 months until treatment goals are reached. Common medicines include:
- Pain relievers (analgesics).
- Corticosteroids and NSAIDs to reduce inflammation.
- Disease-modifying antirheumatic drugs (DMARDs) to try to slow the course of the disease.
- Biologic response modifiers to reduce inflammation and damage.
- Physical therapy and occupational therapy.
- Surgery, if you have severe joint damage. Joint replacement or fusing of joints may be needed.
Your health care provider will work with you to identify the best treatment option for you based on assessment of the overall disease activity in your body.
Follow these instructions at home:
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Start an exercise program as told by your health care provider.
- Rest when you are having a flare.
- Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
- Keep all follow-up visits as told by your health care provider. This is important.
Seek Additional Information
- American College of Rheumatology: www.rheumatology.org
- Arthritis Foundation: www.arthritis.org
Contact a health care provider if:
- You have a flare-up of RA symptoms.
- You have a fever.
- You have side effects from your medicines.
Get help right away if:
- You have chest pain.
- You have trouble breathing.
- You quickly develop a hot, painful joint that is more severe than your usual joint aches.