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Rheumatoid Arthritis
Medical Questions » Rheumatoid Arthritis
| Name: Rheumatoid Arthritis |
| Also known as: |
| An inflammatory disease that affects the entire body, and is not limited to the joints. The main effect is inflammation (swelling and redness) of the smooth moist synovial membrane that lines the inside of joints. Those most affected are the hands and feet. |
Causes of Rheumatoid Arthritis
An autoimmune disease in which the immune system is triggered off inappropriately, and the body starts to reject its own tissue. Tends to run in families from one generation to the next, and the onset may be triggered by a viral infection or stress. Occurs in one in every 100 people, and females are three times more frequently affected than males. Usually starts between 20 and 40 years of age. |
Symptoms of Rheumatoid Arthritis
Initial symptoms are very mild, with early morning stiffness in the small joints of the hands and feet, loss of weight, a feeling of tiredness and being unwell, pins and needles sensations, sometimes a slight intermittent fever, and gradual deterioration over many years. Occasionally the disease has a sudden onset with severe symptoms flaring in a few days, often after emotional stress or a serious illness. As the disease worsens, it causes increasing pain and stiffness in the small joints, progressing steadily to larger joints, the back being only rarely affected. The pain becomes more severe and constant, and the joints become swollen, tender and deformed. Other organs may also be affected. |
Tests for Rheumatoid Arthritis
Diagnosed by specific blood tests, X-rays, examination of joint fluid and the clinical findings. The level of indicators in the blood stream can give doctors a gauge to measure the severity of the disease and the response to treatment. |
Treatment for Rheumatoid Arthritis
Requires constant care by doctors, physiotherapists and occupational therapists. The severity of cases varies greatly, so not all treatments are used in all patients, and the majority will only require minimal care. In acute stages, general physical and emotional rest, and splinting the affected joints are important. Physiotherapists undertake regular passive movement of the joints to prevent permanent stiffness developing, and apply heat or cold as appropriate to reduce the inflammation. In chronic stages, carefully graded exercise under the care of a physiotherapist, is used. Medications for the inflammation include aspirin and other anti inflammatory drugs. Steroids such as prednisone give dramatic, rapid relief from all the symptoms, but they may have long-term side effects (eg. bone and skin thinning, fluid retention, weight gain, peptic ulcers, lowered resistance to infection, etc.), and their use must balance the benefits against the risks. In some cases, steroids may be injected into a particularly troublesome joint. A number of unusual drugs are also used, including gold by injection or tablet, antimalarial drugs (eg. chloroquine) penicillin (not the antibiotic), and cell-destroying drugs (cytotoxics). Surgery to isolated, painful joints can be useful in a limited number of patients.
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Complications of Rheumatoid Arthritis of its treatment
Additional effects can include wasting of muscle, lumps under the skin, inflamed blood vessels, heart and lung inflammation, an enlarged spleen and lymph nodes, dry eyes and mouth, and changes to cells in the blood. |
Likely Outcome of Rheumatoid Arthritis
There is no cure, but effective controls are available for most patients, and the disease tends to burn out and become less debilitating in old age. Some patients have irregular acute attacks throughout their lives, others may have only one or two acute episodes at times of physical or emotional stress, while others steadily progress until they become totally crippled by the disease. |
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