Rheumatoid Arthritis

RA can be difficult to diagnose because symptoms are similar to those of other conditions. The only way to diagnose rheumatoid arthritis is through testing, including blood tests and X-rays, plus a physical history. Talk with your doctor about symptoms that concern you.

Rheumatoid Arthritis (RA) is an inflammatory disease of the joints and organs, in which the immune system attacks the body's tissues by mistake. There are two types of RA. Type 1 is generally less severe and lasts only a few months. Type 2 is a chronic illness, which can last for years or a lifetime. Symptoms come and go, sometimes disappearing for extended periods before returning.

More than 2 million American adults have RA. The condition can affect anyone, but women are 3 times more likely to develop the disease. Onset is typically between ages 25 and 50, but children and young adults can also be affected.

Symptoms
When the disease is active, patients first report joint stiffness, which typically decreases during the day, only to return the next morning. Other symptoms include pain, swelling, fatigue, loss of appetite, feeling feverish and inflammation of bodily organs. Lumps under the skin known as rheumatoid nodules may also develop.

RA usually affects both sides of the body in the same way. The small joints of the hands, wrists, feet and knees are especially vulnerable.

Causes
Although the cause of RA is not known, a variety of factors are believed to contribute. These include infection, the environment, heredity and hormones.

Effect on Joints
Bones meet at the joints and each joint is surrounded by a protective joint capsule lined with a covering known as the synovium. The joint capsule is filled with lubricating synovial fluid, which supplies oxygen and nutrients to the cartilage that covers and protects the ends of bones.

With RA, the immune system attacks the synovium. The tissue responds by becoming inflamed, causing the synovium to thicken and swell and eventually form a destructive tissue called pannus. In turn, pannus harms the joint's cartilage and bone. Over time, this process can result in the breakdown of joints and deformity.

Treatment
Presently, there is no known cure for RA. Your doctor and other medical professionals can help reduce symptoms and relieve discomfort with a treatment plan that may include:

• Over-the-counter and prescription drugs to manage pain and swelling
• Disease-modifying anti-rheumatic drugs (DMARDs) to slow the progress of the disease
• Biologic response modifiers to slow the autoimmune response
• Rest and exercise to reduce inflammation, stiffness and weakness
• Lifestyle changes to accommodate symptoms
• Joint surgery
• Alternative medications
• Physical and or occupational therapy, which may include splint of affected joints
• Surgery to improve function, decrease pain and improve motion. This may include arthroscopy debridement and/or total joint replacement (arthroplasty).