Rheumatoid arthritis

 

 

Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects the joints. It is a chronic disease that gradually worsens with time, causing inflammation in the joints and resulting in painful deformity and immobility. It especially affects small joints of the fingers, wrists, feet, and ankles.

 

 

While the exact cause is still unknown, it is believed to be caused by a combination of these factors:

1. Genetic factors: RA is hereditary in nature. Certain genes have been identified that increase the risk for RA.

2. Environmental factors: Certain environmental factors play a major role. These include smoking, exposure to silica, insecticides, and air pollution

3. Infections: Certain bacteria, viruses, and fungi are believed to increase the risk of RA.

4. RA is an autoimmune disorder where the immune system starts attacking our own body. The antibodies present in bloodstream target body’s own tissues and this results in inflammation.

5. RA is three times more common in women as compared to men. The prevalence rate increases after the age of 40 years.

6. A strong family history of RA increases the chances of a person being diagnosed with it.

 

 

1. RA is a systemic disease, which means that the inflammation can affect other organs too apart from joints.

2. RA generally starts with tenderness and pain in small joints simultaneously in both right and left sides followed by stiffness or swelling which limits joint movement.

3. Small joints of hand, feet, and neck are commonly involved. Some people may also experience loss of appetite, fever, rash, and fatigue.

Typically, the symptoms subside and flare-up alternatingly over weeks to a month. So, there might be a symptom-free period for months followed by a sudden flare-up.

 

 

1. Diagnosis of RA is mainly through a detailed history of signs and symptoms, examination followed by x-rays and confirmatory blood tests.

2. In the blood test, testing for the presence of rheumatoid factor (RF) and anticitrullinated protein antibody (ACPAs) is done.

3. Other tests like ESR, C-reactive protein, kidney function, liver test, and full blood count are also performed.

 

 

Treatment of RA involves one or more of the following drugs based on severity of the symptoms,

1. Medications: Analgesics such as NSAIDS (nonsteroidal anti-inflammatory drugs) and DMARDs (disease modifying anti-rheumatic drugs) are used to treat the pain and inflammation, and decrease joint damage.

2. Surgery: Synovectomy, i.e., removal of the damaged joint lining is performed to give relief. At a later stage, joint replacement surgery might be needed.

3. Physiotherapy: Physiotherapy is recommended to keep joints supple and flexible. Regular exercise is a must to maintain overall physical function. Hot water bag or electric heating bags can be used to give temporary relief from joint pain and swelling on a daily basis.

4. Diet: A diet rich in omega-3 fatty acid and gamma-linolenic acid have proved to reduce joint pain, tenderness, and stiffness.

 

 

Inflammation at a later stage can affect other organs in our body. Signs and symptoms related to other organs due to RA:

1. Lungs: Inflammation of the membrane that surrounds the lung can lead to shortness of breath.

2. Heart: Inflammation around the heart which can cause chest pain.

3. Eyes: Inflammation of glands of eyes which can result in pain, redness, and sensitivity to light.

4. Blood: Lowers red blood cell count and leads to anemia

5. Skin: Rheumatoid nodules (firm lumps that form under the skin close to the affected joints. Size may be variable (from pea-sized to walnut-sized), RA is also known to increase the chances of skin cancer in patients.