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Rheumatoid arthritis

What is Rheumatoid arthritis?

Rheumatoid arthritis (RA) is a chronic inflammatory disease that may cause pain in joints and damage to whole body. In some cases, a wide range of damage can be caused such as skin, lungs, eyes, heart and blood vessels and body systems. Rheumatoid arthritis causes joint damage to both sides of your body.

Rheumatoid arthritis is an autoimmune disease, it occurs when your immune system start attacking to its own body tissues mistakenly.

Rheumatoid arthritis causes joint pain by affecting the lining of your joints, which cause a painful swelling and this may result in bone erosion and joint deformity, unlike wear and tear damage of osteoarthritis.

The inflammation related to rheumatoid arthritis is which can damage other parts of the body. In fact, there are latest medications that have improved treatment but in severe cases rheumatoid arthritis can cause physical damage disabilities.

Rheumatoid arthritis vs osteoarthritis

Osteoarthritis is a condition which is caused by mechanical wear and tear on joints and rheumatoid arthritis is an auto immune disorder related to joints, in which your immune system attacks its own tissues.

Causes of rheumatoid arthritis:

Rheumatoid arthritis starts developing when your immune system starts attacking the synovium (lining of the membranes that surrounded the joints). This will result in inflammation thickens the synovium, which may eventually destroy the cartilage and bone within the joint. The ligaments and tendons are responsible for holding joint together. Gently, the joint starts losing its shape and alignment.

Specialists don’t have the idea what begins this, although a genetic part shows up likely. While your genes don’t really cause rheumatoid arthritis, they can make you increasingly helpless to natural variables, for example, contamination with certain infections and microorganisms or bacteria that may trigger the disease.

Symptoms of rheumatoid arthritis:

In early rheumatoid arthritis, only small joints are affected first such as joints that attach your fingers to your hands and your toes to your feet.

As the rheumatoid arthritis progresses, symptoms spreads to the wrists, knees, ankles, elbows, hips and shoulders. The rheumatoid arthritis symptoms occur in both part of body mostly.

The symptoms for rheumatoid arthritis include:

  • Joint pain
  • Joint stiffness usually worse in the morning
  • Joint swelling, warm and tenderness
  • Fatigue, fever and loss of appetite
  • Loss of joint function and deformities

Other symptoms experienced by about 40% of people who have rheumatoid arthritis, occurs without any involvement of joint. The non-joint structures affected by rheumatoid arthritis includes:

  • Eyes
  • Lungs
  • Heart
  • Skin
  • Salivary glands
  • Nerve tissue
  • Bone marrow
  • Kidney
  • Blood vessels

The symptoms of rheumatoid arthritis can come and go and can vary from mild to severe. Do not ignore these symptoms, you can get a better management and treatment if your disease is diagnosed early.

Diagnosis of rheumatoid arthritis:

The diagnosis of rheumatoid arthritis may require multiple lab tests to confirm clinical examination findings. It takes time to diagnose a rheumatoid arthritis. Your physician will utilize a few apparatuses to analyze rheumatoid arthritis.

In the first place, they’ll get some information about your indications and clinical history. They’ll likewise take a physical examination of your joints. This will include:

  • Look for swelling and redness
  • Examine at joint capacity and range of movement
  • Touch the affecting area or joint to check tenderness and warmth
  • Test your reflexes and muscle strength

If they suspect rheumatoid arthritis, they will refer you to rheumatologist (specialist).

Since no single test can give confirmation that you have rheumatoid arthritis, your rheumatologist or physician may get you some more tests:

They may test your blood for specific substances like antibodies, or check the degree of specific substances like acute phase reactants that are raised during inflammatory conditions. These tests can be an indication of rheumatoid arthritis and help in the determination.

They may likewise demand certain imaging tests, for example, an ultrasound, X-ray, or MRI.

Tests show that how damage the joint is and also the severity of damage.

A total assessment and observing of other organ frameworks may be suggested for certain individuals with rheumatoid arthritis, as well.

Blood tests for rheumatoid arthritis include:

There are a few sorts of blood tests that help your physician or rheumatologist decide if you have rheumatoid arthritis. These tests include:

Rheumatoid factor test: The RF blood test is test for rheumatoid factor, a protein. Higher levels of rheumatoid factor are related with autoimmune disease, especially rheumatoid arthritis.

Anticitrullinated protein antibody test (anti-CCP): This test searches for an antibody that is related with rheumatoid arthritis. Individuals who have this antibody usually have the disease. Though, not every person with rheumatoid arthritis tests positive for this antibody. The anti-CCP Ab is more explicit for rheumatoid arthritis than the RF test.

Antinuclear antibody test: The antinuclear antibody board tests your immune system to check whether it’s creating antibodies. Your body may make antibodies as a reaction to various sorts of conditions, including rheumatoid arthritis.

Erythrocyte sedimentation rate: The ESR test decides the level of inflammation in your body. The results tell physician whether inflammation is present. Though, it doesn’t demonstrate the reason for the inflammation.

C-reactive protein test: An extreme infection or significant inflammation anyplace in your body can trigger your liver to make C-reactive protein. Increased levels of this inflammatory marker are related with rheumatoid arthritis.

Imaging tests:

Your physician may recommend x-rays to check the progress of rheumatoid arthritis in joints over the time. They also recommend for MRI and ultrasound to see the severity of the disease in your body.

Treatments for rheumatoid arthritis:

There is no specific cure for rheumatoid arthritis but there are treatments which help you to manage it. In any case, clinical investigations demonstrate that reemission of symptoms is almost certain when treatment starts right on time with prescriptions known as disease modifying antirheumatic drugs (DMARDs).

Medications:

Type of medications may depend on the severity of your symptoms and how long you have rheumatoid arthritis.

Steroids: corticosteroid medications, like prednisone helps to reduce the inflammation and pain and slows the joint damage. There are some side effects which include weight gain, thinning of bones and diabetes. Physicians prescribe a corticosteroid frequently to relieve acute symptoms.

NSAIDs: Non steroid anti-inflammatory drugs, these drugs are prescribed by your physician to reduce inflammation and relieve pain. Side effects may include; stomach irritation, kidney damage and heart problems.

Disease-modifying antirheumatic drugs (DMARDs): These drugs slow the progression of rheumatoid arthritis by blocking your immune system response. These drugs save your joints from permanent damage. Side effects may include bone marrow suppression, severe lung disease and liver damage, these side effects may vary.

Biologic agents: These biologic agents may be an effective treatment for the people who don’t response to more traditional DMARDs. These are the new generation biologic DMARDs which provide targeted response to inflammation rather than blocking your entire immune system response.

Janus kinase (JAK) inhibitors: these are a new type of DMARDs that works by blocking certain immune responses. These drugs may prescribe by your physician to prevent inflammation and stop damage to your joints, if DMARDs and biologic agents won’t work for you.

Therapy:

Your physician may send you to a physical or occupational therapist who can encourage you to do activities to help keep your joints flexible. The therapist may likewise recommend better approaches to do every day tasks, which will be simpler on your joints. Assistive gadgets can make it simpler to avoid stressing your painful joints.

Surgery:

If medications are not work well to prevent rheumatoid arthritis or slowing the joint damage then your doctor consider surgery to fix the damaged joints. Surgery can be helpful to reestablish your capacity to utilize your joint. It can also improve functioning and reduce pain.

Rheumatoid arthritis surgery may include at least one of the following procedures:

Synovectomy: Surgery to evacuate the inflamed lining of the joint (synovium) can be performed on knees, elbows, wrists, fingers and hips.

Ligament fix: Inflammation and joint damage may make ligaments around your joint torn or rupture. Your surgeon might have the option to fix the ligaments around your joint.

Joint fusion: Surgically fusing a joint might be prescribed to balance out or realign a joint and for relief from discomfort when a joint replacement isn’t a choice.

Total joint replacement: During the replacement surgery, your surgeon removes the damaged pieces of your joint and insert a prosthesis made of metal and plastic.

Surgeries carries a danger of bleed, sepsis and pain. Talk about the advantages and dangers with your doctor.

Types of Rheumatoid arthritis:

There are various types of rheumatoid arthritis, by knowing which type of Rheumatoid arthritis you have may help your doctor to give you best treatment. Types of rheumatoid arthritis include:

Seropositive Rheumatoid arthritis: You will have a positive rheumatoid factor blood test result if you have a seropositive rheumatoid arthritis. This means that your immune system is producing antibodies to attack your joints.

Seronegative Rheumatoid arthritis: You may have seronegative rheumatoid arthritis, if you have a negative rheumatoid factor blood test result and a negative anti-CCP result.

Juvenile idiopathic arthritis (JIA): This refers to the children who develops rheumatoid arthritis at the age of 17 years old and younger. Previously this condition was named as Juvenile Rheumatoid Arthritis (JRA).

Risk factors of Rheumatoid arthritis:

These factors may increase the risk of Rheumatoid arthritis:

  • Gender: Women are more likely to develop rheumatoid arthritis than men.
  • Age: Rheumatoid arthritis can develop at any age, but most commonly it begins in middle age.
  • Obesity: Obesity may cause a numerous disease but the women of age 55 and younger who are overweight are more likely to develop rheumatoid arthritis.
  • Smoking: Smoking cigarette can increase the risk of getting rheumatoid arthritis. If you have a genetic tendency for developing the disease, the smoking also appears to be dissociated with greater disorder severity.
  • Family history: If any of your family member has rheumatoid arthritis then there is an increased chance of getting the disease.
  • Environmental exposures: Some exposures such as asbestos or silica can increase a chance of developing a rheumatoid arthritis. Also, exposure to certain bacteria such as those related to periodontal disease.
  • Trauma: If you ever had a history of trauma or injury related to bone fracture, joint dislocation, and ligament damage then you have an increased risk of developing the rheumatoid arthritis

Complications

If you have rheumatoid arthritis you have increased risk of having:

  • Osteoporosis
  • Rheumatoid nodules
  • Dry eyes and mouth
  • Infections
  • Lung disease
  • Heart problems
  • Carpal tunnel syndrome
  • Lymphoma
  • Abnormal body composition