Rheumatoid arthritis (RA) is a type of arthritis which has long-term consequences and leads to the inflammation of the joints and the surrounding tissue. Rheumatoid arthritis is also one of a hundred different arthritic conditions that can affect other organ systems in the body. Researchers know that this is an autoimmune disease that has caused the chronic inflammation. Autoimmune diseases are illnesses that happen when the body’s tissue is mistakenly attacked by their own immune system. Individuals who suffer from an autoimmune disease will have antibodies in their blood system targeted to their own body tissue. And, because rheumatoid arthritis can affect multiple other organs in the body, it is also referred to as a systemic illness and sometimes rheumatoid disease.
Rheumatoid arthritis is one of the more common rheumatic diseases and affects approximately 1.3 million people in the United States. The disease attacks more women than men but affects people of all races equally. Researchers have found that the disease can begin at any age but more often starts after the age of 40 and before the age of 60. There is some belief that there is a genetic basis for the disorder because in families multiple members can be affected.
Rheumatoid arthritis, or rheumatoid disease, is a chronic illness but some patients can experience long periods of time without symptoms. However, it is also a progressive illness that has the potential to cause joint destruction and eventual disability.
Some of the common signs and symptoms of rheumatoid arthritis include joint pain, joint swelling, red and puffy hands, nodules under the skin on the arms often referred to as rheumatoid nodules, fatigue, fever, weight loss, morning stiffness that can last for several hours, and joints that are tendered to the touch. In the early stages the arthritis tends to affect the smaller joints, the joints in the wrist, hands, ankle and feet. As time progresses the shoulders, elbows, hips, jaw and neck can also become involved.
In many cases, rheumatoid arthritis affects the body in a symmetrical fashion. This means that if your first finger on your left hand is affected then it is likely that the first finger on your right hand will also be affected. These signs and symptoms can vary in severity and can even come and go. Some patients will experience flare ups which occur after a period of decreased disease activity. This means that they will experience periods when they are in relative remission or have no swelling, pain, difficulty sleeping or weakness. This will alternate with times when the disease has an increased amount of activity, called a flare up.
If the joint is not used for a while it can become warm, tender and stiff. As the lining of the joint becomes inflamed there is more fluid produced and the joint becomes swollen. Patients can also suffer from symptoms that include anemia because the bone marrow fails to produce enough new red blood cells, eye burning or itching, numbness or tingling and paleness. Most of these symptoms occur from the affects of rheumatoid arthritis on other bodily organ systems.
The exact causative factor of rheumatoid arthritis is not yet known. In the past infectious agents, such as bacteria, viruses and fungi, have been suspected although none have been proven. It is suspected that certain factors in the environment may also trigger the activation of the immune system in individuals who are already susceptible to an immune mediated disease.
Individuals often present to the physician with swollen and tender joints. The doctor will review the history of symptoms, examine the joints, the skin for rheumatoid nodules and may x-ray certain parts of the body looking for degeneration. The diagnosis is based on a pattern of symptoms, blood work and x-ray findings. Your primary care physician will then recommend you confirm your diagnosis and receive your treatment protocols with a rheumatologist. This is a doctor who has received special training in the treatment and diagnosis of arthritis.
One significant diagnostic criteria is an antibody in the blood system called “rheumatoid factor” that is found in 80% of the patients who suffer from rheumatoid arthritis. Another antibody, citrulline antibody, is present in most patients with rheumatoid arthritis and is also useful in the diagnosis. Citrulline antibody is looked for when there is a previously undiagnosed inflammatory arthritis without the presence of rheumatoid factor. Other blood tests which will be used are a sedimentation rate and C-reactive protein.
At this point the rheumatologist will classify the severity of the arthritis based on the results of the diagnostic x-rays. The basis of the treatment protocols will be the classification of severity in order to reduce the pain, inflammation and degeneration.
Rheumatoid arthritis will cause joint damage that patients can find to be debilitating and disfiguring. Some damage may make it impossible to complete daily activities such as dressing, teeth brushing or cooking. At first it may take more energy to complete them but eventually you may not be able to do them at all. Some of the newer treatment protocols are helping to stop joint damage or presented before it occurs in order to continue the activities you enjoy.
At this time there is no cure for rheumatoid arthritis although medications can help to reduce inflammation. Physicians will also recommend occupational and physical therapy to teach you how to protect the joints you are using, to prevent and decrease the amount of damage that is being done. Medications may include nonsteroidal anti-inflammatory drugs, steroids, disease modifying antirheumatic drugs, immunosuppressants, alpha inhibitors and other drugs which target a variety of inflammatory substances in order to decrease the inflammation in the joints and organ systems.
It is important to continue to be evaluated and treated by a rheumatologist when you are diagnosed with rheumatoid arthritis. This helps to prevent as much joint damage as possible, improve the likelihood you will remain functional as you grow older and decrease the necessity for a potential joint replacement surgery.