Rheumatoid Arthritis Guidelines

Rheumatoid arthritis is a chronic arthritic condition that attacks the synovium, or lining of the joints, causing inflammation and progressive damage to the joints of the body. According to the Arthritis Foundation, 1.3 million people in the United States have rheumatoid arthritis. People of any age are susceptible to rheumatoid arthritis, with those in middle age affected most often. There is no cure for the condition, but with treatment, people are able to lead full lives.

Cause

• The exact cause of rheumatoid arthritis is not known, but genes play a part in who develops the condition. The American Academy of Orthopedic Surgeons states that in people with the gene for rheumatoid arthritis, an infection, or other outside factor, will trigger an autoimmune response in which the body produces substances that attack the lining of the joints.

Symptoms

• Early symptoms associated with rheumatoid arthritis include tender joints that are painful and swell, joint warmth, hands that are red and puffy, fatigue and weight loss, firm nodules under the skin of the arms, fever and stiffness that last for at least 30 minutes in the mornings. Later symptoms of rheumatoid arthritis include deformities of joints, anemia and possibly hammertoes in those with the disease for a long time.

Considerations

• Symptoms of RA usually start in the small joints of the body such as the hands, wrists, ankles and feet. With disease progression, larger joints start showing symptoms.

Stages

• There are three stages to the progression of rheumatoid arthritis. The first stage, in which swelling of the synovial lining of the joints takes places, causes the early symptoms. In the second stage, the synovium thickens due to the rapid division and growth of cells. The third stage consists of the inflamed cells releasing enzymes, which can digest cartilage and bone, leading to the more serious symptoms of RA such as deformity.

Diagnosis

• Along with physically examining the joints and asking about symptoms, a physician will run blood tests to check for specific markers that lead to RA such as low red blood count, which could point to anemia, high white blood cell count that suggests infection, and low white blood cell count, which could mean Felty's syndrome, a common condition associated with RA. Blood tests will also show high levels of platelets in the blood along with elevated sedimentation levels, suggesting inflammation. C-reactive protein, rheumatoid factor and antinuclear antibody tests also are performed to make a diagnosis of rheumatoid arthritis, along with X-rays, ultrasound, MRI and bone density tests.

Treatment

• Early treatment for rheumatoid arthritis is the best way to slow progression and ensure quality of life. Treatment options for RA include medications for pain and inflammation reduction and surgery to replace joints, repair tendons and remove the lining between joints to reduce pain.