What
is Rheumatoid Arthritis?
Rheumatoid arthritis is the other most common type of arthritis.
It is more common in women and affects 7 million Americans…or one
out of every five arthritis patients. It may affect any age group,
although onset is most common in middle age.
Rheumatoid arthritis is usually characterized by heat, swelling,
and pain in multiple joints in both the right and left sides of the
body, including the hands, wrists, elbows, hips, knees, ankles, and
feet. Spinal involvement also occurs on occasion.
The typical pattern of rheumatoid arthritis in the hands involves
the proximal interphalangeal (PIP) joints, the metacarpal phalangeal
(MCP) joints, the wrists, and the elbows.
Unlike osteoarthritis, rheumatoid arthritis can affect the entire
body. People with this disease may feel sick all over…tire
easily…lose their appetite…and lose weight.
In rheumatoid arthritis, the tissue that surrounds and nourishes
the joints is attacked by the body’s immune system. The body
mistakenly perceives its own tissue as foreign, and it reacts by
sending special white blood cells and toxic chemicals called
cytokines to destroy the foreign material. (The cytokine
abnormalities that cause the damage in rheumatoid arthritis are
different from the abnormalities seen in osteoarthritis.) This
process of white cell migration and cytokine release damages the
joint.
Although we do not know the cause of rheumatoid arthritis,
researchers are investigating several possibilities.
Another interesting point about rheumatoid arthritis is that this
disease can affect the internal organs including the lungs, skin,
blood vessels, spleen, heart, and muscles.
If rheumatoid arthritis is not well controlled it can damage the
joints irreversibly and cause serious disability.
To diagnose rheumatoid arthritis, the rheumatologist establishes
the presence of joint pain and inflammation lasting at least six
weeks and then looks for signs of the course of the disease that are
characteristic for rheumatoid arthritis.
There are also blood tests that aid in the diagnosis of
rheumatoid arthritis.
Patients with rheumatoid arthritis have a series of flare-ups
followed by a period where there are mild or no symptoms. Usually,
the pain and disability of rheumatoid arthritis progresses
gradually.
Morning stiffness generally lasts longer than half an hour and
may last several hours depending on the severity of the condition.
Although there is no cure for arthritis, proper treatment can
help tremendously. The goal of arthritis treatment is to relieve the
pain and stiffness due to the progressive destruction caused by
inflammation, and to maintain or increase freedom of movement.
Among the advancements that have taken place in the medical
treatment of arthritis are various disease-modifying medications
that not only relieve symptoms but also help slow down the
progression of disease.
Other advances include various cartilage sparing drugs, cartilage
growing drugs, and also biologic remedies. These drugs act by
blocking the destructive effects of enzymes such as metalloproteases
in osteoarthritis and cytokines in rheumatoid arthritis. By
targeting specific processes, relief of symptoms and healing of
damage can take place with presumably fewer side effects.
Source: Nathan Wei
Dr. Wei (pronounced “way”) is a board-certified
rheumatologist and Clinical Director of the nationally respected
Arthritis and Osteoporosis Center of Maryland. He is a Clinical
Assistant Professor of Medicine at the University of Maryland School
of Medicine and has served as a consultant to the Arthritis Branch
of the National Institutes of Health.
