Rheumatoid arthritis

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Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder that primarily affects the joints but can also have systemic effects on the body. Here are some key points about RA:

Causes and Risk Factors

  • Autoimmune Response: RA occurs when the immune system mistakenly attacks the synovium, the lining of the membranes that surround the joints.
  • Genetic Factors: Family history can increase risk; certain genetic markers (e.g., HLA-DR4) may be associated with RA.
  • Environmental Factors: Smoking, exposure to certain pathogens, and obesity may trigger or exacerbate the condition.
  • Hormonal Factors: RA is more common in women, suggesting that hormones may play a role.

Symptoms

  • Joint Symptoms: Swelling, tenderness, and stiffness in the joints, particularly in the morning or after periods of inactivity.
  • Systemic Symptoms: Fatigue, fever, and weight loss may accompany joint symptoms.
  • Bilateral Affects: RA typically affects joints on both sides of the body symmetrically (e.g., hands, wrists, knees).
  • Nodules: Rheumatoid nodules can develop under the skin, especially at pressure points.

Diagnosis

  • Physical Examination: Assessment of joint swelling, deformity, and range of motion.
  • Blood Tests: Tests for rheumatoid factor (RF), anti-citrullinated peptide antibodies (ACPA), and inflammatory markers (e.g., ESR, CRP).
  • Imaging: X-rays, ultrasound, or MRI may be used to assess joint damage and inflammation.

Treatment

  • Medications:
    • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): To reduce pain and inflammation.
    • Corticosteroids: For short-term relief of inflammation.
    • Disease-Modifying Anti-Rheumatic Drugs (DMARDs): Such as methotrexate, to slow disease progression and prevent joint damage.
    • Biologic Response Modifiers: Target specific pathways in the inflammatory process, often used for moderate to severe cases.
  • Physical Therapy: Exercise and physical therapy can help maintain joint function and reduce stiffness.
  • Lifestyle Modifications: Weight management, exercise, and a healthy diet can also help manage symptoms.

Complications

  • RA can lead to joint damage and deformities if not effectively treated.
  • It may also increase the risk of cardiovascular disease, lung disease, and certain cancers.

Prognosis

  • With early diagnosis and aggressive treatment, many individuals with RA can manage their symptoms effectively and maintain a good quality of life. Some may experience periods of remission.

If you have specific questions or need more information about a particular aspect of rheumatoid arthritis, feel free to ask!