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What Is It?
Rheumatoid arthritis (rue-ma-TOYD arth-write-tis) involves inflammation in
the lining of the joints and/or other internal organs. RA typically affects
many different joints. It can be chronic, which means it lasts a long time,
and can be a disease of flares (active) and remissions (little to no
activity).
RA is a
systemic disease that affects the entire body and is one of the most common
forms of arthritis. It is characterized by the inflammation of the membrane
lining the joint, which causes pain, stiffness, warmth, redness and
swelling. The inflamed joint lining, the synovium, can invade and damage
bone and cartilage. Inflammatory cells release enzymes that may digest bone
and cartilage. The involved joint can lose its shape and alignment,
resulting in pain and loss of movement.
What Are the Symptoms?
Symptoms
include inflammation of joints, swelling, difficulty moving and pain. Other
symptoms include:
 | Loss of appetite |
| Fever |
| Loss of energy |
| Anemia |
| Sometimes rheumatoid nodules (lumps of tissue under the skin) |
| Can affect other parts of the body. |
What Causes It?
The
cause of rheumatoid arthritis is not yet known. However, it is known that RA
is an autoimmune disease. The body's natural immune system does not operate
as it should, resulting in the immune system attacking healthy joint tissue
and causing inflammation and subsequent joint damage.
Researchers suspect that agent-like viruses may trigger RA in some people
who have an inherited tendency for the disease. Many people with RA have a
certain genetic marker called HLA-DR4. Researchers know that there are other
genes that influence the development of RA.
What Are the Effects?
Early in
the disease, people may notice general fatigue, soreness, stiffness and
aching. Pain and swelling may occur in the same joints on both sides of the
body and will usually start in the hands or feet. RA affects the wrist and
many of the hand joints, but usually not the joints that are closest to the
fingernails (except the thumb). RA also can affect elbows, shoulders, neck,
knees, hips and ankles. It tends to persist over prolonged periods of time,
and over time, inflamed joints may become damaged. Other features include
lumps, called rheumatoid nodules, under the skin in areas that receive
pressure, such as the back of the elbows.
How Is It Diagnosed?
It is
important to diagnose RA early in the course of the disease, because with
the use of disease-modifying drugs, the condition can be controlled in many
cases. Physicians diagnose RA based on the overall pattern of symptoms,
medical history, physical exam, X-rays and lab tests including a test for
rheumatoid factor. Rheumatoid factor is an antibody found in the blood of
about 80 percent of adults with RA. However, the presence or absence of
rheumatoid factor does not indicate that one has RA.
Treatment Options
Highly
effective drug treatments exist for rheumatoid arthritis. Early treatment is
critical. Current treatment methods focus on relieving pain, reducing
inflammation, stopping or slowing joint damage, and improving patient
function and well-being. Medications can be divided into two groups
| Symptomatic medications, such as
NSAIDs and aspirin,
analgesics, and
glucocorticoids, help reduce joint pain, stiffness and swelling. These
drugs may be used in combination. |
|
Disease-modifying medications include low doses of methotrexate,
leflunomide, D-Penicillamine, sulfasalazine, gold therapy, minocycline,
azathioprine, hydroxychloroquine (and other antimalarials), cyclosporine
and
biologic agents. |
People with moderate to severe RA who have not responded well to
disease modifying anti-rheumatic drugs (DMARDs) may opt to try
Prosorba therapy.
In addition, treatment most often involves some combination of exercise,
rest, joint protection, and physical and occupational therapy. Surgery is
available for joints that are damaged and painful. A balance of rest and
exercise can help conserve energy and maintain range of motion and use of
the joints.
Who Is At Risk?
| Rheumatoid arthritis affects 2.1 million Americans, mostly women |
| Onset is usually in middle-age, but often occurs in the 20s and 30s
|
| 1.5 million women have rheumatoid arthritis compared to 600,000 men
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Other Information
Musculoskeletal conditions such as rheumatoid arthritis cost the U.S.
economy nearly $65 billion per year in medical care and indirect expenses
such as lost wages and production.
Resources and Suggestions
We
Also Suggest:
| Consult your physician for appropriate diagnosis and treatment.
Your local chapter
can provide a listing of physicians who specialize in arthritis-related
conditions. |
|
Learn to manage your condition -- get involved! Exciting events,
volunteer activities and programs, such as the Arthritis Self-Help Course,
support groups and exercise programs (consult your physician). Use the
Chapter Locator to find activities near you. |
|
Arthritis Today magazine -- Search for more information or
visit Your Arthritis Store to subscribe on-line! |
| Your
Arthritis Store -- books, newsletters, Arthritis Foundation
membership, videos and more. |
|
Arthritis Today Drug Guide |
|
Alternative and Complementary Therapies |
|
Arthritis Today Supplement Guide |
| Frequently
asked questions about arthritis, treatments and coping skills.
|
|
Arthritis in children, teens and young adults. Check out the
information for parents and teachers, too! |
| How to
Care for Yourself |
| Remember, you're not alone! Connect with other people on
Message
Boards. |
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