What is Rheumatoid Arthritis?

What is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is a chronic autoimmune disease that primarily affects the joints, causing inflammation, pain, swelling, and, eventually, joint damage. Unlike osteoarthritis, which results from wear and tear, RA occurs when the immune system mistakenly attacks the lining of the joints (synovium). This leads to persistent inflammation and can affect other parts of the body, including the skin, eyes, lungs, heart, and blood vessels.

Key Features of Rheumatoid Arthritis:

• Autoimmune Disease: The immune system attacks healthy tissues, leading to chronic inflammation.
• Systemic Condition: Can affect multiple joints and organs.
• Symmetrical Joint Involvement: RA typically affects the same joints on both sides of the body.
• Progressive: If untreated, it can lead to joint deformity and disability.

Commonly Affected Joints:

• Hands (e.g., fingers and wrists)
• Knees
• Ankles
• Feet
• Shoulders
• Elbows

Symptoms:

1. Joint Symptoms:

   • Pain, swelling, and stiffness, especially in the morning (morning stiffness lasting more than 30 minutes is a hallmark symptom).
   • Warmth and redness in affected joints.
   • Symmetrical joint involvement.

2. Systemic Symptoms:

   • Fatigue and weakness.
   • Low-grade fever.
   • Loss of appetite and weight loss.
   • Rheumatoid nodules (firm lumps under the skin near affected joints).

3. Long-Term Complications:

• Joint deformities (e.g., swan neck deformity in fingers).
• Damage to cartilage, bones, and surrounding tissues.
• Organ involvement (e.g., lungs, heart, eyes).

Causes and Risk Factors:

1. Immune System Malfunction: The exact cause is unknown, but the immune system targets the synovium, leading to inflammation and joint damage.
2. Genetics: Family history of RA increases susceptibility.
3. Environmental Factors:
   • Smoking is a major risk factor.
   • Exposure to certain infections or bacteria may play a role.
4. Gender: Women are more likely to develop RA than men.
5. Age: Typically begins between 30-50 years but can occur at any age.

Diagnosis:

1. Medical History and Physical Exam:

   • Assessing joint swelling, tenderness, and range of motion.
   • Checking for symmetrical joint involvement and systemic symptoms.

2. Lab Tests:

   • Rheumatoid Factor (RF): An antibody present in most people with RA.
   • Anti-Cyclic Citrullinated Peptide (Anti-CCP): Highly specific for RA.
   • Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP): Indicate inflammation levels.

3. Imaging Tests:

• X-rays, ultrasounds, or MRIs to detect joint damage and inflammation.

Treatment and Management:

RA has no cure, but early and aggressive treatment can manage symptoms, reduce joint damage, and improve quality of life.

1. Medications:

   • Disease-Modifying Antirheumatic Drugs (DMARDs): E.g., Methotrexate, Hydroxychloroquine. These slow disease progression.
   • Biologic Therapies: Target specific parts of the immune system (e.g., TNF inhibitors, IL-6 inhibitors).
   • Corticosteroids: For short-term inflammation control.
   • NSAIDs: For pain and inflammation relief.

2. Lifestyle Changes:

   • Regular, low-impact exercise (e.g., yoga, swimming).
   • Maintaining a healthy weight to reduce joint stress.
   • Stress management techniques.

3. Physical and Occupational Therapy:

   • Exercises to maintain joint flexibility and strength.
   • Adaptive devices to support daily activities.

4. Surgical Options (in advanced cases):

• Joint replacement.
• Tendon repair or joint fusion.

Prevention:

While RA cannot be prevented due to its autoimmune nature, the risk can be reduced by:

• Avoiding smoking.
• Maintaining a healthy lifestyle with regular exercise and a balanced diet.
• Early diagnosis and treatment to prevent progression.

Proper management and early intervention can significantly reduce the impact of RA on daily life.