F A Q

What Is It? How Is It Diagnosed?
What Are the Symptoms? Treatment Options

What Causes It?

Who Is At Risk?

What Are the Effects?

Other Information

                    

What Is It?

Rheumatoid arthritis (rue-ma-TOYD arth-write-tis) involves inflammation in the lining of the joints and/or other internal organs. RA typically affects many different joints. It can be chronic, which means it lasts a long time, and can be a disease of flares (active) and remissions (little to no activity).

RA is a systemic disease that affects the entire body and is one of the most common forms of arthritis. It is characterized by the inflammation of the membrane lining the joint, which causes pain, stiffness, warmth, redness and swelling. The inflamed joint lining, the synovium, can invade and damage bone and cartilage. Inflammatory cells release enzymes that may digest bone and cartilage. The involved joint can lose its shape and alignment, resulting in pain and loss of movement.

What Are the Symptoms?                                                                                                                          Top

Symptoms include inflammation of joints, swelling, difficulty moving and pain. Other symptoms include:

  • Loss of appetite
  • Fever
  • Loss of energy
  • Anemia
  • Sometimes rheumatoid nodules (lumps of tissue under the skin)
  • Can affect other parts of the body.

What Causes It?                                                                                                                                             Top

The cause of rheumatoid arthritis is not yet known. However, it is known that RA is an autoimmune disease. The body's natural immune system does not operate as it should, resulting in the immune system attacking healthy joint tissue and causing inflammation and subsequent joint damage.

 tendency for the disease. Many people with RA have a certain genetic marker called HLA-DR4. Researchers know that there are other genes that influence the development of RA.

What Are the Effects?                                                                                                                                 Top

Early in the disease, people may notice general fatigue, soreness, stiffness and aching. Pain and swelling may occur in the same joints on both sides of the body and will usually start in the hands or feet. RA affects the wrist and many of the hand joints, but usually not the joints that are closest to the fingernails (except the thumb). RA also can affect elbows, shoulders, neck, knees, hips and ankles. It tends to persist over prolonged periods of time, and over time, inflamed joints may become damaged. Other features include lumps, called rheumatoid nodules, under the skin in areas that receive pressure, such as the back of the elbows.

How Is It Diagnosed?                                                                                                                          Top

It is important to diagnose RA early in the course of the disease, because with the use of disease-modifying drugs, the condition can be controlled in many cases. Physicians diagnose RA based on the overall pattern of symptoms, medical history, physical exam, X-rays and lab tests including a test for rheumatoid factor. Rheumatoid factor is an antibody found in the blood of about 80 percent of adults with RA. However, the presence or absence of rheumatoid factor does not indicate that one has RA.

Treatment Options                                                                                                                                 Top

Highly effective drug treatments exist for rheumatoid arthritis. Early treatment is critical. Current treatment methods focus on relieving pain, reducing inflammation, stopping or slowing joint damage, and improving patient function and well-being. Medications can be divided into two groups

  • Symptomatic medications, such as Naiads , aspirin, and analgesics, help reduce joint pain, stiffness and swelling. These drugs may be used in combination.
  • Disease-modifying medications include low doses of methotrexate, leflunomide, D-Penicillamine, sulfasalazine, gold therapy, minocycline, azathioprine, hydroxychloroquine (and other antimalarials), cyclosporine and biologic agents.

People with moderate to severe RA who have not responded well to disease modifying anti-rheumatic drugs (DMARDs) may opt to try Prosorba therapy.

In addition, treatment most often involves some combination of exercise, rest, joint protection, and physical and occupational therapy. Surgery is available for joints that are damaged and painful. A balance of rest and exercise can help conserve energy and maintain range of motion and use of the joints.

Who Is At Risk?                                                                                                                                        Top

  • Rheumatoid arthritis affects 2.1 million Americans, mostly women
  • Onset is usually in middle-age, but often occurs in the 20s and 30s
  • 1.5 million women have rheumatoid arthritis compared to 600,000 men

Other Information

Musculoskeletal conditions such as rheumatoid arthritis cost the U.S. economy nearly $65 billion per year in medical care and indirect expenses such as lost wages and production.

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