Rheumatoid Arthritis
Rheumatoid arthritis is a serious and chronic inflammation
of the joints that can affect other organs as well. It usually begins in the young-to
middle-adult years, and strikes up to three times as many women as men. But anyone of
any race, gender, or age, including children and the elderly, can get Rheumatoid
Arthritis.
Rheumatoid arthritis typically affects joints of the hands and feet but can also
involve the hips, knees, elbows, and other joints. In severe cases, it can cause
inflammation in other parts of the body, including the lungs, blood vessels, and
nerves.
No one knows what causes rheumatoid arthritis, but experts suspect it has something
to do with an autoimmune reaction. The immune system is the body's defense against
disease from invading bacteria, viruses, and other foreign substances. In an autoimmune
disease, the immune system gets off-balance, and attacks the body's own tissues.
Hormones may play a role, since so many more women than men get Rheumatoid Arthritis.
What happens in your joints
Rheumatoid arthritis attacks the lining of the joints (synovium).
The joints become warm, swollen, tender, and difficult to move. If the inflammation
continues, it can destroy cartilage, bone, tendons, and ligaments. The result is
permanent joint deformity and disability.
The pattern and the severity of rheumatoid arthritis varies greatly from person to
person. It can be frustrating and depressing to cope with rheumatoid arthritis, since
the condition can be so variable and so painful. A small number of people -- about one
in 10 -- will have an initial flare-up and go a long time without further episodes. But
most will endure a long-term process with cycles of flares and remissions. A small
percentage may have a severe form of the disease that progresses with no remissions
A person can develop Rheumatoid Arthritis in one of several patterns
A sporadic pattern, with attacks that come and go
A gradual course, with a steady decline and occasional flare-ups
An aggressive disease, with no respite from deterioration
An initial attack, with no return for weeks to months
When rheumatoid arthritis develops slowly, it may first attack
the small joints of the hands and feet with swelling. In more severe or advanced cases,
other areas of the body can become inflamed, including the eyes, blood vessels, lungs,
heart, and nerves. Rheumatoid Arthritis may make you run a fever and ache all over. You
may become anemic, and have dryness of the eyes and mouth caused by inflammation of the
tear ducts and salivary glands.
The view of rheumatoid arthritis has changed considerably over the past two decades.
Doctors used to consider it a crippling, but not a life-threatening disease. Experts
now know that untreated Rheumatoid Arthritis can take years off a person's life. Those
with severe Rheumatoid Arthritis are at especially high risk. Early and aggressive
treatment for all types of Rheumatoid Arthritis is crucial to lessen joint damage and
preserve function.
People with Rheumatoid Arthritis may also have osteoarthritis, especially older people.
Symptoms you may notice
Rheumatoid arthritis typically affects several joints on both sides
of the body, most commonly those of the hands, feet, wrists, knees, elbows, shoulders,
and ankles. It may also start with a nonspecific achiness. Symptoms may come on suddenly
or slowly, and may come and go as the disease becomes active and then inactive.
Pain, warmth, redness, and soreness in the joints
Morning stiffness that lasts more than one hour
Swelling or pain in several joints, on both sides of the body
Fatigue and weakness, and nonspecific aching
Low-grade fever and enlarged lymph nodes
Loss of appetite and weight loss
As rheumatoid arthritis progresses, symptoms may include
Loss of joint function
Inflammation of eyes, mouth, blood vessels, heart, lungs, and nerves
Chest pain, usually associated with arthritis in the ribs, sternum, and spine
Joint deformity
Nodules under the skin
Erosion of joints (seen on X-rays)
How rheumatoid arthritis is diagnosed
Your doctor will perform an examination, take a medical history (and
ask about others in your family who may have had Rheumatoid Arthritis), and order laboratory
tests or X-rays. No single test can definitively diagnose Rheumatoid Arthritis, but a variety
of tests can help rule out other types of arthritis and other diseases.
These tests that help make a diagnosis
Rheumatoid factor (an antibody in the blood)
X-rays, bone scans, or other imaging tests to examine the joints
Your doctor may order any of these other tests
Complete blood count
An ESR (erythrocyte sedimentation rate), which shows inflammation
Liver-function tests and urinalysis to assess the health of internal organs
Your doctor may also order tests to rule out other conditions
ANA (antinuclear antibody)
Antistreptolysin-O Titer (to rule out rheumatic fever)
If the diagnosis still isn't clear -- and especially when primarily one
joint is affected -- your doctor may order a biopsy using a needle to remove fluid or
tissue from your joint (this procedure is sometimes called an aspiration).
Risk factors
Researchers don't know yet why some people's immune systems attack
their own bodies, but several risk factors should be noted.
Being a woman - Three times more women than men get Rheumatoid Arthritis.
Heredity - A susceptibility to immune disorders might be inherited.
Native American ancestry
Long-term smoking - Women who smoke for more than 20 years have a 24% to 39% higher risk of getting Rheumatoid Arthritis.
Infection - Some researchers believe Rheumatoid Arthritis can be triggered by an infection, but no proof exists despite years of searching for an organism.
Toxic Buildup - Other health care professionals believe that a buildup of toxins in the joints, such as heavy metals, undigested proteins from the gut may cause the immune system to attack both joints and organs. (tissue cleansing)
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