The Progression of Rheumatoid Arthritis
RA or rheumatoid arthritis is a progressive
autoimmune illness in which inflammation can cause damage to joints
and other body structures and organs. It can affect any age from
childhood to the senior years but is most common in midlife between
30 and 50 years of age at onset. The more inflammation, the faster
the progression of RA will be and the likelihood of damage and
disability increases proportionately.
While RA can affect all parts of the body, the
disease in the joints is most familiar and one of the easier ways to
observe progression. In the beginning, the autoimmune dysfunction
causes the body to mistakenly treat the synovium, or lining of the
joint, as foreign tissue and attacks it just as it would a microbe
or transplanted tissue. This produces inflammation which causes the
joint to become swollen, tender or painful, hot and red. The
synovium itself swells and encroaches on the space between joint
cartilages.
Further progression of the inflammation will
begin to actually eat away at the cartilage and even the bones
themselves. Loss of cartilage and bone makes joints stiffen and
causes them to become bent and misshapen as the disease progresses.
This is both painful and disabling since the mobility of the joint
is either compromised or lost entirely. Treatment for RA is designed
to arrest the inflammation and interrupt the damage.
This progression can be documented by taking
x-rays over a period of time and observing the changes as the RA
progresses. Stabilizing the joint is an indication that treatment is
effective and continued damage indicates the need for more
aggressive therapy or a change of medications.
When the disease is caught early and effective
treatment is instituted much of the damage from RA may be avoided or
at least greatly limited. Blood tests and other labs can determine
whether the disease is progressing or not. These include examining
the joint fluid or synovial fluid for the presence of excess white
blood cells that indicate inflammation. Blood tests search for
various markers of inflammation including the rheumatoid factor, an
elevated sedimentation rate and an increased CRP test as well as
other markers. Lab tests allow physicians to assess treatment even
before the joint damage has occurred.
Very advanced disease becomes visible to the
naked eye as joints swell and then deform. Hands and feet become
distorted and stiff and there may be lumps called rheumatoid nodules
visible under the skin near large joints as well. Active disease can
also produce other systematic symptoms such as lung disease,
vasculitis in the blood vessels, and stomach distress. The more
progressive the RA becomes, the more likely it is that other body
systems will be affected. Thus, controlling inflammation is the key
to disease control.
Early diagnosis and treatment is the best
defense against the progression of rheumatoid arthritis. Those who
have suspicious symptoms should seek medical care without delay to
avoid the damage associated with untreated RA. For the vast majority
of RA patients, modern medicine offers excellent results and the
prospect of a relatively normal life despite having this incurable
and chronic illness. Research is striving for a cure but in the
meantime good care means a good prognosis for those diagnosed with
RA.
Resources
Following RA progression via X-rays:
www.cnn.com/HEALTH/library/DS/00020.html
Preventing the progression of RA:
www.aafp.org/afp/20000315/tips/12.html
Assessing the risk of RA progression:
www.medscape.com/viewprogram/8628
General information about the progression of
RA:
www.webmd.com/rheumatoid-arthritis/guide/RA-progression