Arthritis Rheumatoid
Rheumatoid arthritis is an inflammatory condition of the joints and other body parts caused by an autoimmune attack on the body by its own defense system. It may have a slow onset or come on suddenly with an acute presentation but is a chronic and as yet incurable condition. In the United States, it is estimated that about 1.3 million people have RA.
RA most commonly appears in people between 30 and 50, but can occur at any age, even early childhood. Women are much more likely to get RA than men, but men seem more likely to have more severe cases. Pregnancy will usually put the disease into remission, but women who have given birth are more likely than average to develop RA in the next year.
Often the small joints such as those of the fingers, hands, wrists and ankles are affected first. The signs and symptoms of RA include stiffness of joints, redness, swelling, pain, heat to the touch and tenderness. There may be bumps under the skin called rheumatoid nodules. Patients also often have fatigue, fever and morning stiffness.
The disease basically has three stages. In the first stage, the synovial membrane (the lining of the joints) becomes inflamed. Next, this tissue begins to swell, and last the enlarged membrane erodes away the joint lining and even eventually can eat away at bone.
RA is diagnosed from a combination of patient history and clinical symptoms, imaging, and laboratory tests. Common blood tests include the RF or rheumatoid factor test which is positive in more than 2/3 of patients, but some people have RA with a negative RF and some people with a positive RF may not be sick at all. This level is also used to check whether a patient is in remission or whether their disease is active. Other tests are the complete blood test, C-reactive protein test, and the ESR or sedimentation rate.
Treatment usually includes some form of physical therapy and may include psychiatric care for associated depression. Medical treatment uses several classes of drugs: analgesics, steroids, NSAIDs, DMARDs, and biologic modifiers. “NSAID” stands for non-steroidal anti-inflammatory drugs, while “DMARD” stands for disease modifying anti-rheumatic drugs. Therapy may require drugs from several of the classes to be effective.
While untreated or undertreated RA can cause severe damage and disability, with good treatment and some lifestyle modifications, RA can be controlled and patients can now often avoid permanent joint damage. Many people also like to add natural or herbal therapies to their regimen if the doctor approves. While the diagnosis may be frightening, people with RA now can lead fairly normal happy and productive lives.
Resources
Wikipedia’s general article on RA: en.wikipedia.org/
Fact sheet on RA by the Rheumatology Society: www.rheumatology.org/
RA Disease Center on the Arthritis Foundation site: www.arthritis.org/
Information from the Mayo Clinic about RA: www.mayoclinic.com/
The excellent About.com pages about RA hosted by a couple who both have the disease: arthritis.about.com/