Rheumatoid arthritis – Condition

We Primary Care - Best Primary Care Knowledge Site

Overview

Rheumatoid arthritis (RA) is an autoimmune and inflammatory illness where your immune system mistakenly attacks and kills healthy cells in your body. As a consequence, inflammation (painful swelling) occurs in the affected regions of your body. It is the joints that are most often affected by RA, and it usually affects a number of joints at the same time. Joints in the hands, wrists, and knees are most often affected by RA. Joint tissue damage occurs when the joint’s lining becomes irritated as a consequence of the inflammation caused by RA. Long-term or chronic pain, unsteadiness (loss of balance), and deformity are all possibilities because of this tissue injury.

The lining of your joints is affected by rheumatoid arthritis rather than the wear and tear damage that occurs as a result of the illness, which is in contrast to osteoarthritis. An excruciating swelling ensues, which may ultimately end in bone erosion as well as joint deformity, in addition to the development of joint degeneration.

Despite the fact that new kinds of medicines have greatly improved treatment choices, severe rheumatoid arthritis may still create physical restrictions in certain people under specific circumstances.

Causes

In a healthy individual, the immune system defends the body against intruders such as germs and viruses. In some individuals, the immune system confuses the body’s cells for foreign invaders in the event of an autoimmune illness such as RA, resulting in the production of inflammatory chemicals that damage the synovium, which is the joint’s cartilage. That is the tissue lining that surrounds a joint and generates fluid to aid in the smooth movement of the joint. As a result of the thickening of the inflammatory synovium,  the joint region becomes difficult to move, painful and sensitive, as well as red and swollen. It is your immune system’s job to help defend your body from infection and illness when it is working correctly. It is believed that rheumatoid arthritis is caused by your immune system attacking healthy tissue in your joints, which causes them to degenerate.

Certain variables seem to have a role in raising the likelihood of getting RA or initiating its start.

The following are some of the factors that may raise your risk for RA:

·Women are more prone to develop RA

·Family history of RA

The following are some of the factors that may contribute to the start of RA:

·Dislocation of the joint or ligament damage

·Individuals who have a history of viral infections, such as the Epstein-Barr virus, which causes mononucleosis

·Individuals who have suffered from trauma or injury

·Cigarette smoking

·Being overweight

Symptoms

RA signs and symptoms include:

·Painful, heated, and swollen joints

·Pain and stiffness in the joints that is typically worst in the mornings

·Fatigue and a lack of appetite

Smaller joints, especially those that connect the fingers and toes to the rest of the body, are more likely to be affected in the early stages of rheumatoid arthritis than bigger joints.

As the disease progresses, wrists, knees, ankles, elbows, hips, and shoulders are often afflicted. The majority of symptoms appear in the same joints on both sides of the body, which makes sense considering how common they are.

The intensity of RA signs and symptoms may vary, and they may appear and disappear at different times during the disease’s course. Flares, or times of heightened disease activity, are often followed by brief periods of relative remission, during which swelling and discomfort diminish or vanish entirely. Rheumatoid arthritis (RA) is a long-term condition that causes joints to distort and slip out of position.

Diagnosis

Because the early signs and symptoms of rheumatoid arthritis are similar to those of many other diseases, it may be difficult to diagnose the disease in its early stages. A diagnosis of this kind cannot be confirmed by a single blood test or physical evidence.

In the course of the physical examination, the doctor will examine joints for signs of edema, redness, and warmth. It is also possible that he or she will test your reflexes and muscular strength.

Blood Test: An increased ESR or a high level of CRP in people with rheumatoid arthritis may suggest the existence of an inflammatory process in the body. A number of blood tests, including rheumatoid factor and anti-CCP antibodies, detect them.

Imaging Test: Your doctor may suggest that you have X-rays of your joints to help track the progression of RA in your joints. The findings of MRI and ultrasound scans may help your doctor determine the severity of your disease.

Treatment

There is currently no treatment for RA. Clinical investigations, on the other hand, have shown that initiating therapy with medicines known as “disease-modifying antirheumatic drugs(DMARDs)” as soon as possible increases the likelihood of achieving remission of symptoms.

·NSAIDs are medications that are used to alleviate pain and inflammation.

·Steroids help to decrease inflammation and discomfort while also slowing the progression of joint degeneration.

·DMARDs/arthralgia help to halt the development of RAalong with preventing irreversible damage to the joints.

Your doctor may send you to an occupational or physical therapist, who will teach you exercises to maintain your joints in good working order. The therapist may also advise new methods to do everyday activities that are less taxing on your joints.

By decreasing the size and weight of your painful joints, assistive devices may make it easier to avoid stressing them. A kitchen knife with a handgrip, for example, may help to protect the joints in your fingers and wrists when chopping. Buttonhooks, for example, may make getting dressed a lot easier for individuals.

When to see a doctor

While occasional joint pain is not a medical emergency, persistent or worsening pain should not be ignored. If you have any of the following symptoms for more than a few weeks, contact your doctor: stiffness in the morning, painful joints, any of your joints may feel heated and low-grade fever and fatigue.

Make an appointment with your doctor as soon as possible, preferably within a week. If you have rheumatoid arthritis, seek treatment right away. Early therapy provides the best chance of decreasing or stopping the disease (including joint and bone damage).