What is Rheumatoid Arthritis

What is RA ?

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).

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.

Researchers suspect that agent-like viruses may trigger RA in some people who have an inherited 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.

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 joints can lose their shape and alignment, resulting in pain and loss of movement.

Rheumatoid arthritis may involve a number of organ systems in the body in addition to the synovial lining of your joints. There may be changes in the lungs themselves, or inflammation of the lining of the lungs (called the pleura), with even production of fluid in the chest cavity.

Rheumatoid arthritis may involve the peripheral nerves leading to numbness and tingling from a neuropathy. The eyes may become inflamed particularly over the white part of the eye with what is called scleritis or episcleritis. In very rare and advanced cases of involvement of the eye, the cornea may thin allowing the contents of the eye to actually perforate, but fortunately this is an extraordinarily rare situation.

Rheumatoid arthritis may affect the bone marrow so that the individual becomes more anemic in spite of taking iron therapy. Some patients may develop severe inflammation of the blood vessels leading to a loss of blood flow to the digits. This may cause serious problems including ulceration of the digits or even in rare and advanced cases gangrene.

Sometimes the sac around the heart may get inflamed (this is called pericarditis). If fluid is produced within the pericardial sac, then this needs to be recognized as it might produce some compression of the heart and interfere with circulation.

Even though I have mentioned these various other manifestations of rheumatoid arthritis aside from the joint involvement, it is important to note that these occur only in the most aggressive forms of this disease. Many of these problems are often associated with high titers of rheumatoid factor, but it is important to appreciate the fact that rheumatoid arthritis is a systemic disease and not just a joint problem.

Therefore, you need to be under the care of someone who is familiar with all of these different ways rheumatoid arthritis may be expressed.

Please visit the Frequently Asked Questions page for more information.