What is Rheumatoid Arthritis?

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a chronic disease that causes symmetrical inflammation, swelling, pain, and stiffness of mainly the small joints of the hands and feet. The inflammation may also affect other organs such as the lungs, blood vessels and eyes.

How does one know if he/she has Rheumatoid Arthritis?

The following symptoms may manifest in patients with Rheumatoid Arthritis:

• Symmetrical stiffness of mainly small joints of hands and feet worse in the morning, lasting for more than 30 minutes
• Loss of energy
• Low grade fevers
• Loss of appetite, weight loss
• Lumps of tissues under the skin (rheumatoid nodules)
• Dry eyes and mouth

Who are at risk/what are the risk factors?

The following places a person at risk of having Rheumatoid Arthritis:

• Individuals with first degree relatives with RA are at a higher risk for the disease
• Women are three times affected than men
• Most common in the 4^th to 6^th decades of life
• Infectious agents (bacteria and viruses) have been considered triggering factors although search for specific etiologic agents are still inconclusive

What happens when you have Rheumatoid Arthritis?

The cause of RA is now know but it was found that the immune system works abnormally in this diseases (termed “autoimmune”), attacking the tissues that line the joint (synovium), through the release of chemicals that cause inflammation. If the inflammation is not controlled, there will be destruction of cartilage and bone leading to joint deformities/erosion and loss of function.

How is Rheumatoid Arthritis diagnosed? Who do you consult?

No single test can diagnose RA; rather, the diagnosis is established by an effective and complete history taking, physical examination, laboratory tests, and exclusion of other diagnoses. For this reasn, you should see a rheumatologist. Rheumatologists are physicians with the competence to correctly diagnose RA and give the most appropriate treatment.

Tests that may aid in the diagnosis of RA:

• Screening for Antibodies: Rheumatoid factor, anti-citrullinated peptides (anti-CCP) are positive in RA
• Markers of inflammation: erythrocyte sedimentation rate (ESR) is elevated
• Anemia (low red blood cell count)
• X-rays may help detect RA but may be normal in early disease
• Ultrasound/Magnetic resonance imaging (MRI) may detect early disease severity

What are the available treatment options?

There is no cure for RA. The goal of therapy is to lessen/relieve symptoms, improve joint function, and delay disease progression thereby preventing disability. Optimal care of RA is tailored for each patient, which is achieved by a combination of pharmacologic, non-pharmacologic, and sometimes surgery.

Pharmacologic/Drug Therapy

• Disease-modifying antirheumatic drugs (DMARDs), these drugs slow the progression of the disease and also relieve symptoms
• Drugs called Biologic Agents
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Corticosteroids

Non-pharmacologic Treatment

• Exercise
• Physical Therapy
• Avoid excessive physical activities

Surgery

• Repair or Join replacement
• Tendon repair

What are the possible complications of Rheumatoid Arthritis?

• Joint damage
• Inflammation of the eye
• Anemia
• Dry eyes and dry mouth (Sjogren’s syndrome)
• Increased risk for Coronary artery disease
• Increased risk for lymphoma and other cancers

How can The Medical City help you?

At the Medical City, we have a complete roster of competent rheumatologists, orthopedic surgeons, and physiatrists who can assess and manage patients with rheumatoid arthritis.

For more information, you may contact:

DEPARTMENT OF MEDICINE, SECTION OF RHEUMATOLOGY

Tel. no. (632) 988-1000 / (632) 988-7000 ext. 6287

Email: rheumatology@themedicalcity.com

References:

1. American College of Rheumatology. (2013, February). Systemic Lupus Erythematosus, from http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Systemic_Lupus?Erythematosus_(Lupus)/
2. Firestein, G. (2008). Kelley’s Textbook of Rheumatology (8^th Ed.), Philadelphia, PA: Saunders.
3. Klippel, J. (2008). Primer on the Rheumatic Diseases (13^th Ed.). New York: Springer.
4. Department of Medicine: Section of Rheumatology, The Medical City

Note: This information is not intended to be used as a substitute for professional medical advise, diagnosis or treatment.   If you or someone you know have any of the symptoms mentioned above, it is advisable to seek professional help.