Rheumatoid Arthritis

What is Rheumatoid Arthritis (RA)?

RA is an autoimmune disorder that causes inflammation of the lining of the joints. The body tissue is mistakenly attacked by its own immune system. RA may also affect the skin, eyes, lungs, heart, blood, or nerves. Rheumatoid arthritis is a chronic disorder, meaning that although there may be occasional symptom-free periods, the disease can worsen over time and may never go away. Early, aggressive treatment is key to slowing or stopping its progression.

RA Symptoms

Joint inflammation from RA comes with pain, warmth, and swelling. The inflammation is typically symmetrical, occurring on both sides of the body at the same time (such as the wrists, knees, or hands). Other symptoms of RA include joint stiffness, particularly in the morning or after periods of inactivity; ongoing fatigue, and low-grade fever. Symptoms typically develop gradually over years, but can come on rapidly for some people.

Who Gets Rheumatoid Arthritis?

Affecting about 1% of the U.S. population, RA usually strikes between ages 30-60, but younger and older people can also be affected. RA occurs two to three times more often in women than in men. Other risk factors include cigarette smoking and family history.

Rheumatoid Arthritis Causes

Immune cells normally protect the body from foreign invaders. What causes them to target healthy joints and tissue is unknown. Researchers believe some combination of genetics and environmental factors may play a role. There may be a genetic tendency in some people who, if they develop an infection with a particular bacterium or virus, go on to develop the condition. But to date, no specific infection has been identified.

RA’s Toll on the Joints

Inflammation of the lining of the joints can destroy cartilage and bone, causing deformity of the joints. As the condition progresses, joints can develop considerable pain and loss of function.

RA’s Toll on the Body

RA can affect organs and areas of the body other than the joints, including:

  • Rheumatoid nodules (shown here): firm lumps under the skin and in internal organs
  • Sjogren’s syndrome: inflammation and damage of the glands of the eyes and mouth; other parts of the body can also be affected
  • Pleuritis: inflammation of the lung lining
  • Pericarditis: inflammation of lining surrounding the heart
  • Anemia: reduction of red blood cells
  • Felty syndrome: reduction of white blood cells, associated with enlarged spleen
  • Vasculitis: blood vessel inflammation, which can impair blood supply to tissues

Juvenile Rheumatoid Arthritis (JRA)

Juvenile RA is the most common type of arthritis in kids. Like adult RA, it causes joint inflammation, stiffness, and damage. However, it can also affect a child’s growth. Juvenile RA is also known as juvenile idiopathic arthritis. “Idiopathic” means no known cause.

RA and Pregnancy

Surprisingly, rheumatoid arthritis improves in up to 80% of women during pregnancy. It will likely flare up after delivery. How and why this happens is still unclear. Changes in your medication may be necessary before you become pregnant and during pregnancy.

Diagnosing RA: Evaluating Symptoms

Because symptoms may come and go, diagnosing RA in its early stages is challenging. If you have these symptoms, your doctor may order further tests:

  • Morning joint stiffness
  • Swelling/fluid around several joints at the same time
  • Swelling in the wrist, hand, or finger joints
  • Same joints affected on both sides of your body
  • Firm lumps under the skin (rheumatoid nodules)

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