Rheumatoid arthritis or RA is a chronic inflammatory disorder that causes joints pain. In a few people, the condition is so severe that it can damage the body system, including heart, blood vessels, skin, eyes or lungs. It is the most common form of autoimmune disorder in which the immune system mistakenly attacks the own body’s tissues. Along with joint pain, it causes stiffness, swelling, and decreased mobility of the joints. Rheumatoid arthritis, unlike the damage of osteoarthritis, affects the lining of joints, causing a painful swelling that can eventually result in deformity of joint & bone erosion.
The damage that rheumatoid arthritis causes usually happens on both sides of the body. That means if a joint is affected in one of the limbs, the same joint on the other side of the limb may be affected too. This feature distinguishes RA from other forms of arthritis.
RA is marked by symptoms of inflammation and joints pain. The other sign and symptoms may include:
Rheumatoid arthritis, in its early stage, tends to affect the smaller joints first, particularly the joints of fingers and toes. As the disease progresses in its further stages, symptoms begin to spread to the wrists, knees, ankles, elbows, shoulders and thighs.
Many people affected with RA also experience signs and symptoms that not only involve the joints but other parts of the body too. Rheumatoid arthritis can affect many non-joint structures, including:
RA is a type of autoimmune disease. The immune system is supposed to attack foreign particles in the body, by the mechanism of inflammation. In an autoimmune disorder, the immune system mistakenly sends inflammation to its healthy tissue. In rheumatoid arthritis, the immune system attacks synovium. Synovium is the lining of the membrane that surrounds the joints. The immune system produces a lot of inflammation that is sent to joints causing pain and swelling. If the inflammation persists for an extended period, it can cause severe damage to the joint, which cannot be reversed once it occurs. The actual cause of RA is not known. There are evidence and researches that suggest autoimmune conditions may run in families.
Factors that may increase the risk of developing rheumatoid arthritis are:
Gender – Women are more prone to the risk of RA than men.
Age – Rheumatoid arthritis can affect an individual at any age, but it most commonly begins in middle age and more often seen in older age.
Family history – If a family member has a history of rheumatoid arthritis, the chances to acquire rheumatoid arthritis increases.
Smoking – Smoking cigarettes also increases the risk of developing rheumatoid arthritis. Smoking appears to be associated with greater disease severity.
Obesity – People, especially women of age 50 and younger who are overweight or obese, appear to be at a higher risk of acquiring RA.
Rheumatoid arthritis increases your risk of developing:
Osteoporosis – Rheumatoid arthritis, along with some medications used for treating rheumatoid arthritis, can increase the risk of acquiring osteoporosis. It is a chronic condition that weakens the bones and makes them more prone to fracture.
Rheumatoid nodules – These solid bumps or clumps of tissues commonly form around pressure points, such as the elbows or knees. However, these clumps can form anywhere in the body, including the lungs also.
Dry eyes and mouth – Individuals who have rheumatoid arthritis are much more likely to experience Sjogren’s syndrome. It is a disorder in which the amount of moisture content in the eyes and mouth gradually decreases.
Infections – The disease itself with many of the medications used to treat rheumatoid arthritis may impair the immune system, making it more prone to infections.
Abnormal body composition – The ratio of fat to lean mass is often higher in people who have rheumatoid arthritis. This is also seen in people who have a normal body mass index (BMI).
Carpal tunnel syndrome – If rheumatoid arthritis affects the wrists, the inflammation can compress the nerve that serves most of the hand and fingers.
Heart problems – RA may increase the risk of hardened and blocked arteries, as well as inflammation of the sac that encloses the heart.
Lung disease – People affected with RA have an increased risk of inflammation and scarring of the lung tissues. This can further lead to progressive shortness of breath.
Rheumatoid arthritis might be challenging to diagnose in its very initial stages. This is because the early signs and symptoms are similar to those of many other diseases.
During the physical examination, the doctor will check the joints for swelling, redness, warmth, and other signs of inflammation. The doctor may also test muscle strength and reflexes. X-rays can be helpful in detecting RA. Further, MRI and ultrasound scanning can be done to help confirm or analyze the severity of RA.
[Always consult your physician before performing any tests and for further information]
There are several blood tests that help doctors or rheumatologist determine whether someone has RA. These tests include:
Rheumatoid factor test – The RA Factor blood test checks the level of a protein known as the rheumatoid factor. Increased levels of rheumatoid factor can be a sign of autoimmune diseases, especially RA.
Anticitrullinated protein antibody test (Anti-CCP) – This test looks for an antibody that is associated with RA. People who have this antibody in their bloodstream may have the disease. Please note, not everyone who may have RA can test positive for this antibody. The anti-CCP Ab (antibody) is more specific for detecting rheumatoid arthritis than the RF test.
C-reactive protein test – A severe infection or remarkable inflammation, anywhere in the body, can trigger the liver to produce C-reactive protein. High levels of C- reactive protein can be associated with RA.
Antinuclear antibody test – The antinuclear antibody examines the immune system to see if it’s producing antibodies. The human body produces several antibodies as a response to many diseases, including RA.
Erythrocyte sedimentation rate – The ESR test helps in determining the degree of inflammation in the body. The result of ESR helps the doctor to see whether inflammation is present. However, the test does not indicate the cause of the inflammation.
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