Rheumatoid Arthritis: Symptoms, Treatment

Overview

Rheumatoid arthritis (RA) is the most common form of autoimmune arthritis that causes chronic inflammation and pain in the joints and other areas of the body. Autoimmune diseases occur when the body’s immune system mistakenly attacks the body’s tissues. The joint damage that RA causes usually happens on both sides of your body.

RA affects about 24.5 million people all over the world as of 2015, among which about 1.5 million are from the United States. In women, RA mostly begins between ages 30 and 60. In men, it often occurs later in life. Having a family history of RA may increase your odds of having the disease. Luckily, with early diagnosis and proper treatment, patients with RA can live a normal life.

Causes

Experts still don’t know why some people develop RA while others do not. But they do understand the trigger mechanism of the disease: abnormal response of the immune system causing joint inflammation and damage. Some indicated risk factors for RA include:

  • Gene

Researches have shown that people with a specific genetic marker called the HLA shared epitope are five times more likely to develop RA than people without the marker. Other genes that may be connected to RA include STAT4, TRAF1, C5, and PTPN22. All in all, if a member of your family has RA, you may have an increased risk of developing the disease.

  • Gender

According to statistics, about 75% of RA patients are women. In fact, 1- 3% of women may get RA in their lifetime.

  • Age

The most dangerous age group for women to get RA is 30-50 years old. For men, RA usually occurs in older age. However, it is worth noting that RA can start at any age.

  • Smoking

Cigarette smoking puts you at higher risk of developing RA.

  • Obesity

People who are overweight or obese appear to be at higher risk of having the disorder as well.

Symptoms

RA signs and symptoms may vary in severity and may even reoccur. In the early stage, it tends to affect your smaller joints first, particularly the joints that attach your fingers to your hands and your toes to your feet. As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips, and shoulders. General signs and symptoms of RA include:

  • Tenderness, warmth of joints
  • Swelling and stiffness of joints
  • Fatigue
  • Fever
  • Anemia
  • Loss of appetite
  • Dry eyes and mouth
  • Firm lumps beneath the skin in places such as the elbow and hands
  • Inflammation and scarring in the lungs that can lead to shortness of breath

Diagnosis

Diagnosing RA can be time-consuming and may require multiple lab tests to confirm. First, your doctor will ask about your symptoms and medical history. He or she will also perform a physical exam of your joints to look for inflammation and redness, as well as testing your range of motion and muscle strength.

Lab tests that can support the diagnosis of RA are:

  • Blood tests

Erythrocyte sedimentation rate (ESR, or “sed rate”) and C-reactive protein (CRP) are used to check for signs of inflammation. An antibody called Rheumatoid factor (RF) is found in about 80% of people with RA. Anti-cyclic citrullinated peptide (anti-CCP), another antibody linked with the disease, occurs in nearly 60% to 70% of RA patients. Blood tests showing the presence of the above-mentioned one or two antibodies can help diagnose the condition.

  • Imaging tests

An X-ray, ultrasound or MRI scan may be done to look for joint damage. But if the imaging tests don’t show joint damage, that doesn’t rule out RA. It may mean that the disease is in an early stage and hasn’t yet damaged the joints.

Treatment

There is no cure for RA. The goal of treatment is to reduce joint pain and swelling and to improve the ability to perform daily activities.

Studies indicate that remission of symptoms is more likely when treatment begins early with disease-modifying antirheumatic drugs (DMARDs), such as methotrexate (Trexall, Otrexup, others), hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine). They can help control the progression of the disease and protect the joints from permanent damage. Other medications that can be used include:

JAK inhibitors is a new subcategory of DMARDs to block the Janus kinase, or JAK, pathways, which are involved in the body’s immune response. The most typical and often used type for treating RA is tofacitinib.

Physical therapies can help keep your muscle strength and joints flexible. Surgery for RA can be an important option for people with permanent damage that limits daily function, mobility and independence.


Keyword: rheumatoid arthritis (RA).

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* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.