Rheumatoid arthritis

Description

Rheumatoid Arthritis is an autoimmune disease, characterized by chronic inflammation of the lining of the joints (synovium) that leads to severe pain hampering daily life. Rheumatoid arthritis may also affect other areas of the body including the skin, eyes, heart, lungs, and kidneys. It usually affects both sides of the body in symmetry, like both legs are affected simultaneously, differentiating it from other forms of arthritis.

Causes

Autoimmunity is found to be the main cause of rheumatoid arthritis. Other causes may also play a role in the development of Rheumatoid Arthritis, including:

Bacterial infections
Viral infections
Obesity
Emotional trauma.

Risk factors

However the exact cause of rheumatoid arthritis is unknown there are certain risk factors that might increase the risk of developing rheumatoid arthritis. They are as follows:

Hereditary (a strong family history of RA increases the chances of a person being diagnosed with it)
Environmental factors (Certain environmental factors play a major role. These include smoking, exposure to silica, insecticides, and air pollution)
Infections (Certain bacteria, viruses, and fungi are believed to increase the risk of RA)
Sex (rheumatoid arthritis is three times more common in women as compared to men)
Genetic factors (rheumatoid arthritis is hereditary in nature. Certain genes have been identified that increase the risk for RA)

Symptoms

Rheumatoid Arthritis is inflammation of the joints along with other clinical manifestations. Symptoms include:

Rheumatoid Arthritis and joints
Joint pain
Joint tenderness
Joint stiffness that is worst in the morning
Joint swelling

Systemic manifestations:
Anemia
Fatigue
Rheumatoid nodules (bumps under skin usually at elbows)
Pleurisy (chest pain that worsens with breathing)
Pericarditis (inflammation of heart lining)
Cataract
Scleritis
Myositis (inflammation of muscles).

Diagnosis

Diagnosis is done by:

Through examination, taking extensive history to evaluate signs and symptoms.
Blood tests (to test the presence of rheumatoid factor and anti-citrullinated protein antibody)
X-rays (to examine deformities that are typical to rheumatoid arthritis)
Other tests like CBC (complete blood count),ESR, kidney function test, liver test may also be performed to determine damage caused to other organs)

Management

Treatment usually involves:

Medications:

Steroids (reduces pain, inflammation and damage of the joints)
NSAIDS (Nonsteroidal anti-inflammatory drugs reduce pain and swelling)
DMARDS (Disease modifying anti-rheumatic drugs slows down the progression of the disease)
Immunosuppressants (controls the immune system of the patient)

Physical exercise to keep the joints supple and flexible.
Hot water bag or electric heating bags can be used to give temporary relief from joint pain and swelling on a daily basis.
Synovectomy ( some patients may need surgery to correct joint damage)
Diet (consume omega-3 foods, bone broth and higher fiber foods e.g. whole grains, citrus fruits, cherries, garlic)

When to consult a doctor?

Rheumatoid arthritis and the medications that are used to treat it may affect other organs of the body e.g. lungs, heart, eyes and skin. If one suffers from chest pain or pain in the eye or shortness of breath or anemia (reduced amount of red blood cells) along with joint pain then a medical professional should be consulted.