Rheumatoid Arthritis is an autoimmune, chronic, progressive, systemic disease that mainly affects the joints. It typically causes heat rise, swelling, and pain in the joints. It also affects other organs in the body, and as a result, it can cause low red blood cell count, lung inflammation, and heart inflammation. It is one of the most common inflammatory rheumatic diseases in the world and is more common in women between the ages of 20-50.
The immune system of the individuals who genetically susceptible to RA development and autoimmunity may be triggered as a result of exposure to smoking, bacteria, viruses, and other environmental components.
Findings and Symptoms
Fever, sweating, weakness, and weight loss are the initial symptoms. Joint findings are polyarticular, symmetrical, and deforming. Pain, morning stiffness, swelling, temperature increase, and loss of function occur in the joints, with no rash. Finger joints, wrists, elbows, knees, shoulders, and hips are the most commonly affected areas. Buttonhole Deformity, Ulnar Deviation, and Swan Neck Deformity may occur in the hands in the late stages. Small pieces called rheumatoid nodules may form under the skin, near the affected joint. These pieces can be the size of a pea or a walnut. Other findings are vasculitis, pericarditis, Sjögren's syndrome, uveitis, anemia, and amyloidosis.
The goal of treatment is to reduce pain, suppress inflammation, slow down or stop joint damage, and improve well-being and function. Non-Steroid Anti-inflammatories, glucocorticoids, synthetic and biological DMARDs can be used in the treatment.
1- "Handout on Health: National Institute of Arthritis and Musculoskeletal and Skin Diseases. August 2014. Retrieved July 2, 2015.
2- Majithia V, Geraci SA (2007). "Rheumatoid arthritis: diagnosis and management".Am. J. Med. 120 (11): 936–9.
3- Scott DL, Wolfe F, Huizinga TW (Sep 25, 2010). "Rheumatoid arthritis". Lancet 376 (9746): 1094–108.
4- Doherty, M; Lanyon, P; Ralston, SH. Musculosketal Disorders-Davidson's Principle of Internal Medicine (20th ed.). Elsevier. pp. 1100–1106.
5- Plenge RM, Seielstad M, Padyukov L, Lee AT, Remmers EF, Ding B, Liew A, Khalili H, Chandrasekaran A, Davies LR, Li W, Tan AK, Bonnard C, Ong RT, Thalamuthu A, Pettersson S, Liu C, Tian C, Chen WV, Carulli JP, Beckman EM, Altshuler D, Alfredsson L, Criswell LA, Amos CI, Seldin MF, Kastner DL, Klareskog L, Gregersen PK (2007)."TRAF1-C5 as a Risk Locus for Rheumatoid Arthritis — A Genomewide Study". N. Engl. J. Med. 357 (12): 1199–209.
6- Madhok R, et al. Ann Rheum Dis 1993; 52:232–234.
7- Choy E. Rheum Dis Clin N Am 2004; 30:405-415
8- Nicki R. Colledge, Brian R. Walker, Stuart H. Ralston, eds. (2010). Davidson's principles and practice of medicine. (21st ed.). Edinburgh: Churchill Livingstone/Elsevier.ISBN 978-0-7020-3084-0.
9- "An approach to Early Arthritis". Pn.lifehugger.com. 12 January 2009. Archived fromthe original on May 27, 2010.
10- Gaffo A, Saag KG, Curtis JR (2006). "Treatment of rheumatoid arthritis". Am J Health Syst Pharm 63 (24): 2451–2465.
11- Shah, Ankur. Harrison's Principle of Internal Medicine (18th ed.). United States: McGraw Hill. p. 2738.
12- Schueller-Weidekamm C. Modern ultrasound methods yield stronger arthritis work-up. Diagnostic Imaging. May 2010:20–22.
13- Westwood OM, Nelson PN, Hay FC (2006). "Rheumatoid factors: what's new?".Rheumatology (Oxford) 45 (4): 379–85.
14- Nishimura K, Sugiyama D, Kogata Y, Tsuji G, Nakazawa T, Kawano S, Saigo K, Morinobu A, Koshiba M, Kuntz KM, Kamae I, Kumagai S (2007). "Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis". Ann. Intern. Med. 146 (11): 797–808.
15- Nishimura K; Sugiyama D; Kogata Y; Tsuji, G; Nakazawa, T; Kawano, S; Saigo, K; Morinobu, A; et al. (2007). "Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis". Ann. Intern. Med. 146(11): 797–808.
16- Radner H, Ramiro S, Buchbinder R, Landewé RB, van der Heijde D, Aletaha D; Ramiro; Buchbinder; Landewé; Van Der Heijde; Aletaha (Jan 18, 2012). Radner, Helga, ed. "Pain management for inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and other spondylarthritis) and gastrointestinal or liver comorbidity". Cochrane database of systematic reviews (Online) 1: CD008951.
17- McCormack PL (2011). "Celecoxib: a review of its use for symptomatic relief in the treatment of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis". Drugs 71 (18): 2457–89.
18- Marks JL, Colebatch AN, Buchbinder R, Edwards CJ; Colebatch; Buchbinder; Edwards (Oct 5, 2011). Marks, Jonathan L, ed. "Pain management for rheumatoid arthritis and cardiovascular or renal comorbidity". Cochrane database of systematic reviews (Online)(10): CD008952.