Rheumatoid Arthritis

Summary about Disease


Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder that primarily affects the joints. In RA, the body's immune system mistakenly attacks its own tissues, specifically the synovium (the lining of the joints). This leads to inflammation, pain, swelling, stiffness, and eventually, joint damage and disability. RA can also affect other organs, including the skin, eyes, lungs, heart, and blood vessels.

Symptoms


Joint pain, tenderness, swelling, stiffness

Stiffness is often worse in the morning or after inactivity

Fatigue

Fever

Loss of appetite

Weight loss

Dry eyes and mouth

Rheumatoid nodules (bumps under the skin)

Inflammation can also affect the eyes, lungs, heart, blood vessels, and skin

Causes


The exact cause of rheumatoid arthritis is not fully understood. It is believed to be a combination of genetic predisposition and environmental factors. Genetic factors can increase the risk of developing RA, but environmental triggers, such as infections, smoking, or exposure to certain substances, are also thought to play a role in initiating the autoimmune response.

Medicine Used


Disease-Modifying Antirheumatic Drugs (DMARDs): Methotrexate, Sulfasalazine, Leflunomide, Hydroxychloroquine

Biologic Agents (biologic DMARDs): Etanercept, Infliximab, Adalimumab, Certolizumab, Golimumab, Abatacept, Rituximab, Tocilizumab, Sarilumab

JAK Inhibitors: Tofacitinib, Baricitinib, Upadacitinib

Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Ibuprofen, Naproxen

Corticosteroids: Prednisone, Methylprednisolone

Is Communicable


No, rheumatoid arthritis is not a communicable or contagious disease. It is an autoimmune disorder, meaning it is caused by the body's own immune system attacking itself, not by an external infectious agent.

Precautions


Early diagnosis and treatment: Starting treatment early can help slow the progression of the disease and prevent joint damage.

Regular exercise: Exercise can help maintain joint mobility, strength, and flexibility.

Healthy diet: A balanced diet can help reduce inflammation and improve overall health.

Rest: Getting enough rest can help reduce fatigue and pain.

Joint protection: Use assistive devices to protect joints from stress.

Smoking cessation: Smoking is a risk factor for RA and can worsen symptoms.

Stress management: Stress can trigger RA flares, so it is important to manage stress levels.

Vaccinations: Certain vaccines may be recommended or contraindicated depending on medications being taken. Discuss this with your doctor.

How long does an outbreak last?


RA does not have outbreaks. RA is a chronic condition with varying symptom intensity. Instead of outbreaks, there are flare-ups where symptoms worsen, followed by periods of remission where symptoms lessen. The duration of a flare-up can vary from days to weeks or even months. Without treatment, RA persists indefinitely.

How is it diagnosed?


Physical Exam: Examining joints for swelling, tenderness, and range of motion.

Blood Tests:

Rheumatoid Factor (RF)

Anti-Cyclic Citrullinated Peptide (anti-CCP) antibody

Erythrocyte Sedimentation Rate (ESR)

C-Reactive Protein (CRP)

Complete Blood Count (CBC)

Imaging Tests:

X-rays: To assess joint damage

Ultrasound: To visualize joint inflammation

MRI: To provide detailed images of joints and surrounding tissues

Timeline of Symptoms


The timeline of RA symptoms varies greatly from person to person.

Early Stages: Gradual onset of joint pain, stiffness, and swelling, often in the small joints of the hands and feet. Fatigue and low-grade fever may also be present. Can develop over weeks to months.

Progression: Symptoms become more persistent and widespread, affecting multiple joints. Joint damage and deformities may develop.

Later Stages (without treatment): Significant joint damage, chronic pain, and disability. Extra-articular manifestations (affecting other organs) may become more prominent.

Important Considerations


RA is a chronic condition that requires ongoing management.

Early diagnosis and treatment are crucial to prevent joint damage and disability.

Treatment plans are individualized based on disease severity and patient response.

Regular monitoring is necessary to assess disease activity and adjust treatment as needed.

Patient education and support are essential for managing RA effectively.

Increased risk of other diseases like heart disease.

Pregnancy requires careful planning and management due to medications.