Theme: iWiki Log in Register

Diff: Rheumatoid Arthritis

Comparing revision #2 (2026-06-22 04:49:08) with revision #3 (2026-06-22 06:09:11).

Old	New

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation of the joints. It primarily affects the synovial joints, causing pain, stiffness, and swelling. RA is a systemic condition, meaning it can affect other parts of the body besides the joints.
	'''Rheumatoid arthritis''' is a long-term autoimmune condition that causes inflammation in joints. It most often affects the hands, wrists, and feet, but it can affect other joints and other parts of the body.

== Overview ==
Rheumatoid arthritis is a relatively common condition, affecting approximately 1% of the global population. It occurs more frequently in women than in men and can develop at any age, although it most commonly begins between the ages of 30 and 50.
	Unlike osteoarthritis, which is mainly linked to wear and structural change in joints, rheumatoid arthritis is driven by the immune system attacking tissue around the joints. Early diagnosis and treatment are important because persistent inflammation can damage cartilage, bone, tendons, and ligaments.

== Symptoms ==	== Symptoms ==
The hallmark symptoms of rheumatoid arthritis include joint pain, swelling, and morning stiffness lasting for more than 30 minutes. The joints affected by RA are usually symmetrical, meaning if one joint on one side of the body is affected, the corresponding joint on the other side will also be affected. Commonly affected joints include the hands, wrists, elbows, knees, and ankles.
	Common symptoms include:

In addition to joint symptoms, individuals with RA may experience fatigue, low-grade fever, loss of appetite, and generalized malaise. Over time, untreated or poorly managed RA can lead to joint deformities, decreased joint function, and disability.
	* Joint pain.
	* Joint swelling.
	* Warmth around affected joints.
	* Stiffness, often worse in the morning or after rest.
	* Fatigue.
	* Reduced grip strength or difficulty using affected joints.
	* Flares, where symptoms become worse for a period.

== Pathophysiology ==
The exact cause of rheumatoid arthritis is unknown, but it is considered an autoimmune disorder. In autoimmune diseases, the immune system mistakenly attacks healthy tissues, in this case, the synovium - the membrane lining the joints. The immune response triggers inflammation, which leads to joint damage and the release of enzymes that erode cartilage and bone.
	The pattern is often symmetrical, meaning joints on both sides of the body are affected. Small joints in the hands, wrists, and feet are common early sites.

Genetic factors, environmental triggers, and abnormal immune responses play a role in the development of rheumatoid arthritis. Certain genes, such as HLA-DRB1, are associated with an increased risk of developing the condition. Environmental factors, such as smoking, hormonal changes, and certain infections, may also contribute to the development or progression of RA.
	== Causes and Risk Factors ==
	Rheumatoid arthritis is an autoimmune disease. The immune system attacks the lining of joints, causing inflammation. Over time, this can damage cartilage and bone.

	The exact trigger is not known. Risk is influenced by a mixture of genetic and environmental factors. NHS information identifies increased risk in women, people with a family history of rheumatoid arthritis, and people who smoke.

== Diagnosis ==	== Diagnosis ==
Diagnosing rheumatoid arthritis involves a combination of medical history, physical examination, imaging tests, and laboratory tests. The criteria established by the American College of Rheumatology are commonly used to guide diagnosis. These criteria consider symptoms, duration of symptoms, and the presence of specific markers in the blood, such as rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies.
	Diagnosis is based on symptoms, examination, blood tests, and imaging. Blood tests may include inflammatory markers, rheumatoid factor, and anti-CCP antibodies. X-rays, ultrasound, or MRI may be used to assess joint inflammation or damage.

Imaging tests, such as X-rays, ultrasounds, or magnetic resonance imaging (MRI), may be used to assess joint damage and monitor disease progression.
	NICE guidance stresses rapid access to specialist care. Early referral to rheumatology is important when persistent synovitis is suspected, especially if small joints are affected, more than one joint is involved, or symptoms have been present for several weeks.

== Treatment ==	== Treatment ==
The treatment of rheumatoid arthritis aims to reduce pain, inflammation, and joint damage, as well as improve joint function and quality of life. The management of RA often involves a multidisciplinary approach, including medications, physical therapy, lifestyle modifications, and regular follow-up with healthcare professionals.
	There is no cure, but treatment can reduce inflammation, control symptoms, prevent or slow joint damage, and help people stay active.

Commonly used medications for RA include:
	Treatment may include:

* Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These medications help reduce pain and inflammation.
* Disease-Modifying Antirheumatic Drugs (DMARDs): DMARDs, such as methotrexate, hydroxychloroquine, or sulfasalazine, are used to slow down the progression of RA and preserve joint function.
* Biologic Response Modifiers: These medications, such as tumor necrosis factor (TNF) inhibitors, target specific components of the immune system involved in RA.
* Corticosteroids: Short-term use of corticosteroids may be prescribed to reduce severe inflammation during flare-ups.
	* Disease-modifying anti-rheumatic drugs, often called DMARDs.
	* Biological or targeted synthetic medicines for people whose disease is not controlled with standard DMARDs.
	* Short courses of corticosteroids in selected situations.
	* Pain relief and anti-inflammatory medicines for symptom control.
	* Physiotherapy and occupational therapy.
	* Podiatry for foot problems.
	* Surgery for severe joint damage in some cases.

Physical therapy and exercise play a crucial role in managing rheumatoid arthritis. They help improve joint flexibility, strength, and function, and reduce pain. Assistive devices, such as splints or orthotics, may be recommended to support affected joints.
	Methotrexate is commonly used as an initial DMARD, but treatment choices depend on disease activity, other health conditions, pregnancy plans, monitoring requirements, and response to previous medicines.

== Complications and Outlook ==
Rheumatoid arthritis is a chronic condition that requires ongoing management. If left untreated or poorly controlled, it can lead to significant joint damage, deformities, and disability. Additionally, RA can affect other parts of the body, leading to complications such as:
	== Treat-to-Target Care ==
	Modern rheumatoid arthritis care often uses a treat-to-target approach. Disease activity is measured regularly, and treatment is adjusted until remission or low disease activity is reached where possible.

* Rheumatoid Nodules: Firm lumps that develop under the skin, typically around pressure points.
* Cardiovascular Disease: Rheumatoid arthritis increases the risk of developing heart disease and stroke.
* Lung Complications: Inflammation in the lungs can lead to conditions such as interstitial lung disease or pleural effusion.
* Eye Problems: Dry eyes, inflammation of the sclera (scleritis), or damage to the cornea (keratitis) can occur in RA.
	This approach is intended to prevent hidden inflammation from continuing to damage joints even when symptoms have partly improved.

With early diagnosis, appropriate treatment, and ongoing management, individuals with rheumatoid arthritis can lead active lives with reduced pain and improved joint function.
	== Living With Rheumatoid Arthritis ==
	Rheumatoid arthritis can affect work, sleep, mood, family life, and everyday tasks such as dressing, cooking, writing, walking, or using a phone. Occupational therapy, workplace adjustments, pacing, exercise, and assistive equipment may help.

== See Also ==
	Exercise is usually encouraged within personal limits because it supports strength, flexibility, cardiovascular health, and mood. During flares, people may need rest, temporary adjustments, and review of treatment.

* [[Autoimmune Disorders]] - Explore a group of conditions where the immune system mistakenly attacks healthy cells and tissues.
* [[Osteoarthritis]] - Learn about a common form of arthritis characterized by the breakdown of joint cartilage.
	== Complications ==
	Possible complications include:

	* Joint deformity or loss of function.
	* Tendon problems.
	* Carpal tunnel syndrome.
	* Eye inflammation or dryness.
	* Lung inflammation or scarring.
	* Increased cardiovascular risk.
	* Osteoporosis, sometimes related to inflammation or steroid use.
	* Infection risk, particularly with some immune-suppressing medicines.

	Good disease control can reduce the risk of some complications.

	== References ==
	* [https://www.nhs.uk/conditions/rheumatoid-arthritis/ NHS: Rheumatoid arthritis]
	* [https://www.nhs.uk/conditions/rheumatoid-arthritis/treatment/ NHS: Rheumatoid arthritis treatment]
	* [https://www.nice.org.uk/guidance/ng100 NICE: Rheumatoid arthritis in adults, management]
	* [https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/rheumatoid-arthritis/ NHS inform: Rheumatoid arthritis]

	[[Category:Rheumatology]]
	[[Category:Autoimmune diseases]]
	[[Category:Medicine]]