RA is an autoimmune disease. Rheumatoid arthritis is a kind of arthritis causing swelling, pain; lose of functioning, and stiffness in bone joints. It can affect any joint, but often it is observed in wrist joints and fingers. It is seen more in women than in men. The symptoms appear and go. If it is in a severe form, then it lasts for lifetime. It attacks on lining of the joints. So it results in swelling, aching, throbbing and deformity. It is different form from osteoarthritis, which is the common form of arthritis. Rheumatoid arthritis may affect body parts near to joints like mouth, lungs and eyes. It attacks on body's own tissues and it results from your immune system. Even simple acts like walking, become difficult in this type.
Causes:
Causes of rheumatoid arthritis are not known. Genes, environment, and hormones may contribute in it.
Risk factors:
- Sex - It develops more in women than men
- Age - Commonly between ages 25 to 55 it starts. Sometimes it is a short termed disease
- Family history - The disease is not inherited but one can inherit a predisposition to rheumatoid arthritis
- Infection - bacterial or viral infections
- Smoking - quitting smoking can reduce your risk of RA
Signs & Symptoms:
- Joint swelling
- Joint pain
- Tender joints, even to touch
- Fatigue
- Fever
- Red and puffy hands
- Morning stiffness lasting at least for 30 minutes
- Weight loss
- Weakness
- Firm bumps of tissue under the skin on arm.
These symptoms occur first in smaller joints, like hands, feet, wrists, ankles. Symptoms are observed in knee, elbow, hip, neck and jaw after disease progression. The severity of symptoms may vary.
Classification:
The American College of Rheumatology has developed a system for classifying rheumatoid arthritis. This system helps medical professionals determine the severity of your rheumatoid arthritis.
Stage I:
- No damage seen on X-rays, although there may be signs of bone thinning
Stage II:
- On X-ray, evidence of bone thinning around a joint with or without slight bone damage
- Slight cartilage damage possible
- Joint mobility may be limited; no joint deformities observed
- Atrophy of adjacent muscle
- Abnormalities of soft tissue around joint possible
Stage III:
- On X-ray, evidence of cartilage and bone damage and bone thinning around the joint
- Joint deformity without permanent stiffening or fixation of the joint
- Extensive muscle atrophy
- Abnormalities of soft tissue around joint possible
Stage IV:
- On X-ray, evidence of cartilage and bone damage and osteoporosis around joint
- Joint deformity with permanent stiffening or fixation of the joint
- Extensive muscle atrophy
- Abnormalities of soft tissue around joint possible
Rheumatologists also classify the functional status of persons with rheumatoid arthritis as follows:
Class I: Completely able to perform usual activities of daily living
Class II: Able to perform usual self-care and work activities but limited in activities outside of work (such as playing sports, household chores)
Class III: Able to perform usual self-care activities but limited in work and other activities
Class IV: Limited in ability to perform usual self-care, work, and other activities
Investigations:
Some of the following tests may be advised by your doctor to know the stage of the disease.
- Complete blood count
- ESR
- C reactive Protein
- Serum electrolytes
- Liver function tests
- Kidney function tests
- Rheumatoid Factor (RF)
- Antinuclear Antibodies (ANA)
- Other nuclear bodies (anti-RA33, anti-CCP)
- Synovial fluid analysis
- X-ray
- MRI
- Ultrasound
- Bone Scanning
- Densitometry
- Arthroscopy
Treatment:
No cure is available for rheumatoid arthritis. Medicines, lifestyle changes and surgery are the treatments use for rheumatoid arthritis. It reduces pain or swelling slow or stops joint damage. Consult a doctor, if you feel constant discomfort and swelling in various joints on both sides of your body. If you are a patient of RA, then consult your doctor on having side effects.
Side effects of medicines:
- Nausea
- Black or tarry stools
- Abdominal discomfort
- Drowsiness
- Constipation
In order to reduce inflammation and relieve pain, the medicines are prescribed by the doctor. Early treatment reduces joint damage and disability risk. If medications cannot prevent the joint damage, then surgery is considered. It helps to restore your joint using ability. It reduces pain and corrects deformities. The surgeries involved are:
- Total joint replacement (arthroplasty) - Here damaged parts are removed and metal or plastic prosthesis is inserted.
- Tendon repair - Tightened or loosen tendons are repaired here.
- Removal of the joint lining (synovectomy) -Inflammation causing lining is removed in this type. Surgery has a risk of pain, bleeding, and infection. So discuss the advantages and disadvantaged of the surgery before.
Prevention:
There is no known way to prevent RA because its exact cause is unknown. People who have the risk factors of RA should be careful as there are no medications or lifestyle modifications (diet, exercise, weight management, physiotherapy, occupational therapy, quitting smoking) to prevent rheumatoid arthritis. When the researchers verify the exact cause of RA, the preventive measures can be decided.