Rheumatoid Arthritis (RA)

Simply Put

Rheumatoid Arthritis (RA) is a chronic, inflammatory autoimmune disease that can overlap with Myositis. The disease involves the lining of the joints, causing the joints to become swollen and inflamed. RA is not a rare disease.  Approximately 41 people out of every 100,000 are diagnosed with this disease. As with most autoimmune diseases, there is no one known cause, and it is more common in women than men.

MSU Observation: When the term “arthritis” is used, people often think of the joint pain and cartilage deterioration caused by age and wear and tear, but that type is “Osteoarthritis,” and is not an autoimmune disorder.

Symptoms

  • Joint tenderness, warmth, and swelling
  • Morning stiffness, sometimes lasting for hours
  • Fatigue
  • Fever
  • Weight loss
  • Anemia
  • Rheumatoid nodules, which are firm bumps of tissue under the skin and are usually found on the arms

The symptoms can vary in severity and can go into periods of remission and, alternatively, periods of increased disease activity, called “flares,” as in many autoimmune diseases.

The inflammation often spreads to the wrists, knees, ankles, elbows, hips, and shoulders and can cause deformity of the joints. RA can also affect skin, eyes, lungs, and blood vessels.

Rheumatoid Arthritis

Image courtesy of healthline.com

Diagnosis

RA is not easy to correctly diagnose, especially in the early stages because the symptoms often mimic those of other diseases. There is no definitive test to confirm the diagnosis with certainty.

A rheumatologist is the specialist most often seen for RA because it is considered a rheumatic disease, one which affects joints and muscles, as well an autoimmune disease. The physician typically will conduct a physical exam which includes inspecting the joints to determine if they are swollen, red and/or warm.

The doctor is also likely to check reflexes and muscle strength and conduct specific blood tests typically elevated in people with RA:

  • ESR (sometimes called sed rate)
  • Rheumatoid factor (RF)
  • Anti-cyclic citrullinate d peptide (anti-CCP) antibodies

X-ray images are often helpful to assist with the diagnosis and to track the progression of the disease over time.

Treatment

There is no cure for Rheumatoid Arthritis, but early and aggressive treatment is a widely accepted strategy by physicians who see RA patients.   A variety of treatment types exist which are helpful to minimize inflammation, relieve pain and discomfort, improve physical function, and to reduce long-term complications such as joint and organ damage.

  • Over-the-counter NSAIDs (such as naproxen sodium and ibuprofen)
  • Prescription oral and topical anti-inflammatories, especially for patients at a higher risk for stomach ulcers
  • Corticosteroids such as Prednisone which are used to quickly get the inflammation under control
  • DMARDs (disease-modifying antirheumatic drugs), which suppress the immune system from attacking the joint tissue
  • Biologics, such as Rituxan, which are injected or infused and can target specific parts of the immune system rather than suppressing the entire immune system
  • JAK Inhibitors, such as Tofacitinib which is a new category of DMARDs, and can be taken orally

Joint replacement surgery may be an option for those with extensive joint damage which impacts their mobility and independence.

Rheumatoid Arthritis

Image courtesy of healthline.com

Simply Put

“Simply Put” is a service of Myositis Support and Understanding, to provide overviews of Myositis-related medical and scientific information in understandable language.

MSU volunteers, who have no medical background, read and analyze often-complicated medical information and present it in more simplified terms so that readers have a starting point for further investigation and consultation with healthcare providers. The information provided is not meant to be medical advice of any type.

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