Rheumatoid arthritis  is a type of arthritis (joint inflammation) in which the joints in the limbs, and sometimes in other parts of the body, become painful swollen, stiff, and, in severe cases, deformed. Tissues that are outside the joints, for example the heart, can also be affected.

RHEUMATOID ARTHRITIS CAUSES AND INCIDENCE

Rheumatoid arthritis is an autoimmune disorder (in which the body’s immune system attacks its own tissues) that usually starts in early adulthood or middle age but can also develop in children (juvenile chronic arthritis) or elderly people. Women are affected more commonly than men. There are usually recurrent attacks.

RHEUMATOID ARTHRITIS SYMPTOMS AND SIGNS

Early symptoms of rheumatoid arthritis include mild fever and aches followed by swelling, redness, pain, and stiffness in the joints, particularly in the morning. Ligaments, tendons, and muscles around the affected joint may also be involved. Rayanaud’s phenomenon (a condition in which the fingers turn white on exposure to cold) may occur and there may also be rheumatoid nodules (small lumps under the skin) over pressure points, such as the elbows or finger joints. Swelling of the wrist may cause carpal tunnel syndrome (tingling and pain in the fingers due to pressure on the median nerve) and also tenosynovitis (inflamed, painful tendon sheaths).

Complications of severe rheumatoid arthritis may include anaemia (a reduced level of the oxygen-carrying pigment haemoglobin in the blood), pericarditis (inflammation of the membranous heart covering), ulcers on the hands and feet, pleural effusion (accumulation of fluid around the lungs), pulmonary fibrosis (scarring and thickening of lung tissue), and Sjogren’s syndrome (in which the eyes and mouth become excessively dry).

RHEUMATOID ARTHRITIS DIAGNOSIS AND TREATMENT

A diagnosis can be confirmed through X-rays of the affected joints and blood tests (including a check for specific antibodies known as rheumatoid factor). Once the diagnosis has been confirmed, treatment with disease-modifying anti-rheumatic drugs (DMARDs) is started as soon as possible to slow down progression of the disease and help prevent further joint damage. These drugs take several weeks to start working and during this period non-steroidal anti-inflammatory drugs (NSAIDs) or, less commonly, corticosteroid drugs may be used to relieve symptoms.

Once the DMARDs have started working, it may be necessary to continue with lower-dose NSAIDs to provide adequate symptom relief. Corticosteroids may also sometimes be used to treat flare-ups of symptoms.

If DMARDs are ineffective or unsuitable, drugs called cytokine inhibitors may sometimes be used instead. These drugs also slow down progression of the disease and help prevent joint damage.

Physiotherapy is needed to prevent or limit deformity and to help relieve symptoms and maintain mobility. People who are disabled by arthritis can be helped to cope with everyday tasks through occupational therapy.

In severe cases, surgery may be performed to replace damaged joints with artificial ones (arthroplasty). Hip and knee replacements are the most common operations of this type.

Most sufferers must continue drug treatment for life, but many can achieve a near-normal level of activity with effective control of their symptoms.

RHEUMATOID ARTHRITIS AND THE BODY

One of the most serious forms of joint disease, rheumatoid arthritis may occur as a single episode or a succession of progressively severe attacks. It results from a disturbance in the body’s immune system, causing the body to attack its own tissues. The joints are usually the worst affected, but other tissues  such as the heart and lungs may also be involved.

Affected joints

Rheumatoid arthritis can affect virtually any joint, but especially the fingers, wrists, shoulders, knees, hips, and spinal joints in the neck.

The hands in rheumatoid arthritis

This condition commonly affects the fingers. Usually, there is pronounced swelling around the knuckles.

Disease progression

The synovium (membrane lining the capsule of an affected joint) becomes inflamed and thickened. Later, inflammation may spread to the cartilage and bone.

Source: A-Z family medical encyclopedia by BMA

Popularity: 2% [?]