Causes and ramifications of Rheumatoid Arthritis


Rheumatoid arthritis is a chronic condition that is seen as a persistent inflammation of lots of joints. Over an extended time frame, this inflammation results irreversible joint damage. Although its cause is unknown, it is usually thought to be auto-immune disorder where the disease fighting capability starts to attack the body's own tissue. ARTHRITIS RHEUMATOID has a world-wide distribution and affects 0. 5-1%, with a lady preponderance, of the population( Kumar & Clarck's, Clinical Medicine).

The disease, causes disability and mortality and can happen from childhood to late later years. The most common age onset is between 30 and 50 years.

Gender, genetics and family are the most crucial risk factors, others include heavy smoking, obesity and a history of blood transfusions.

Gender: This predominance of women with arthritis rheumatoid is mainly due to the fact that diminished immunity is a key point. There is a great risk that a woman will establish arthritis rheumatoid at the menopause because her ovaries must stopped producing hormones oestrogen and progesterone. Women prior to the menopause are affected three times more than men.

Genetics: Genes play a significant role in the development of arthritis rheumatoid, factors are estimated to account for up to 60% of disease susceptibility.

The condition is strongly related to the presence of the protein on the surface of white blood cells called HLA-DR4.


A consultant rheumatologist can treat rheumatoid arthritis, they may be hospital-based doctors with specialist trained in arthritis and other diseases that affect the joints. They have the capability to interpret tests and may suggest more, discuss treatments, prescribe drugs, or make a referral for surgery, if it's required. If the individual undergo surgery, the rheumatologist will manage the rehabilitation by referring the patient to physiotherapists a occupational therapists.


Rheumatoid arthritis starts in different ways. Usually, it starts slowly, with intermittent pain and swelling in a few joints, especially in the fingers, wrist, and feet. I almost 20 per cent of all cases, the condition start very suddenly: 1 day the individual is normal and the next many joints are painful, swollen, and stiff. In some people the condition starts in less typical ways. For example, it may involve only a single joint. In others, the disease comes and goes repeatedly, often over many years, before becoming persistent. Occasionally, it starts with pain stiffness surrounding the shoulders and so mimics an ailment called polymyalgia rheumatica.

There a wide range of key symptoms that doctors look for when they want to identify any kind of arthritis. Sometimes these symptoms are combined with other features, such as loss of function and a sensation of unbearable tiredness or general symptoms that affect your body as a whole.


  1. Pain: Pain in a joint maybe mild, moderate, or severe, and is also usually chronic.


  • Inflammation: Symptom of varied type of inflammatory arthritis.



  • Swelling: Either the liner of the joint swells or fluid flows in to the joint. Swelling usually indicates inflammatory arthritis.



  • Stiffness: Morning stiffness that lasts for over an hour usually indicates a kind of arthritis.


There are also a list of physical examinations that may be required in order to diagnose arthritis rheumatoid:

  • Visual identification of the swelling, redness and structural deformity of the joints, which really is a characteristic of arthritis rheumatoid.


  • Palpation of the joints, which helps to distinguish which kind of arthritis.



  • Pain when moving the joints.


Examinations rarely helps the diagnosis, but it can help evaluate the severity and can pinpoint problems with specific joints. As the arthritis rheumatoid affects the joints leading to pain, it'll limit the patient's ability to move. Household chores, writing, picking up things from the floor and personal care are examples of daily activities that may be affected by arthritis rheumatoid. By doing so, people with rheumatoid arthritis need to make changes in their lifestyle, I order to safeguard their joints and learn how to handle flare-ups and stress.


  1. X-rays: They show joint damage and offer an assessment of its severity and progression. In rheumatoid arthritis, they may reveal lack of bone, which means the presence of erosions nest to the margins of joints. Also, helps the physician decide whether joint replacement surgery is needed.


  • Imaging Techniques:



  • Computerized tomography (CT).



  • Magnetic resonance imaging (MRI).



  • Ultrasound.



  • Isotope bone scans.



  • Dual- energy X-ray absorptiometry (DEXA).


All these imaging techniques provides a more improved image of bones and joints than X-rays Some, particularly MRI and ultrasound, can show inflammation and soft-tissue swelling.

Blood test is also very important to verify the diagnosis of arthritis rheumatoid, they can reveal specific chemicals that are markers of this disease, such as auto-antibodies that react with specific proteins in the body. Blood tests also reveal the amount of haemoglobin, which may indicate anaemia or infection. Also, it measures the amount of enzymes to check on if the liver is working properly, kidney function can be checked as well by measuring the level of waste material. C-reactive protein (CRP) levels is checked to find out any acute inflammation. Also, erythrocyte sedimentation rate(ESR), to assess the body's respond to a damaging situation, such as inflammation or infection.

Orthopaedic surgeons have lots of joint surgeries available within a treatment, each of them aim to decrease pain or prolong the life of any joint. The primary types of joint surgery available include washing out, synovectomy, realignment, fusion, and total replacement.


Diagnosing rheumatoid arthritis requires a team effort involving the patient and many types of healthcare professionals, such as general practitioner, internist and rheumatologist. The diagnose of arthritis rheumatoid in its early stages can be difficult, as there is absolutely no single test for the condition. In addition, symptoms differ from individual to individual and can be more severe in many people than in others. Also, symptoms can be similar


Rheumatoid arthritis can be an autoimmune disorder that the disease fighting capability attacks his or her own body tissue. However there isn't a exact cause yet, there still research on many things that might lead to rheumatoid arthritis. Such as genes, environment and hormones.

It make a difference various systems in the body, such as: cardiovascular, immune, respiratory, nervous, integumentary, endocrine, skeletal and excretory. Also soft tissue surrounding joins, lungs, skin, heart, eyes, kidneys, spleen, lymph nodes, and blood.

The signs that is shown in rheumatoid arthritis are caused by inflamed synovial membrane of one or more joints, leading to pain and swelling. When inflammation spreads to the synovial sheats that protects the tendons, there is progressive and usually irreversible damage to joints. Bony swellings appear and deformity develops as the damage joints get started to fail. Muscles weaken due to lack of use and from the effects of generalized inflammation


Research on rheumatoid arthritis has massively improved the data of the immune system and genetics. Studies to comprehend the introduction of the disease can help finding new therapies that could improve the disease at early stage ( inflammatory process). Although there can be an increased in knowledge about the cause of arthritis rheumatoid, the prognosis still very poor. Two factors to consider before giving the prognosis are:

How early the condition was diagnosed and how old was the individual when first diagnosed.

Research studies claim that conditions such as heart diseases, osteoporosis, stroke, and infections may be more likely. One reason may be that people with rheumatoid arthritis cannot exercise freely. In some instances, the drugs for arthritis rheumatoid can raise blood pressure or weaken the immune system, making infections more likely. About 10 to 20% of rheumatoid arthritis patients have sudden onset of the disease, followed by a long time with no symptoms. That is considered a prolonged remission. (Carol & Richard Eustice, about. com guide).


Current research implies that in the early days of the condition, NSAIDs (Non-steroidal Anti-inflammatory drugs) may provide some rest from the symptoms. However, they don't prevent progressive joint damage. Such damage is mainly treated with DMARDs (Disease-modifying-antirheumatic-drugs). They act slowly, taking several weeks or months to feel their effect. The rheumatologist will determine how long they must be taken as different people respond to individual DMARDs in several ways. If the disease do not react to these, the patient may be considered for a new generation of drugs called biologic agents. They can lessen inflammation and structural harm to the joints by blocking the action of cytokines, proteins of the body's immune system that trigger inflammation during normal immune responses.

When the joints are damaged to the point where the pain cannot be handled with drugs or the joint can barely move, the surgery can be the only answer. The surgeon will need to weigh up the risks and benefits before deciding about surgery. Joint replacement, specifically, requires operating theatres equipped with ultraclean airflow systems to help maintain hygiene and reduce the threat of infection. Trained nursing staff, physiotherapists and occupational therapists are part of the multidisciplinary team working towards effective post-operative recovery and rehabilitation. There are always a good number of professional involved to make any adjustment to the patient's new lifestyle; occupational therapists can help patients to accomplish personal, work, domestic, educational or leisure goals. Also, help prevent or decrease the potential for loosing abilities in the future. A rheumatologist can refer the individual to a occupational therapist, who's specialised in solving issues with rheumatoid arthritis. Therefore, the specialist you have the ability to advice the individual on home adaptations.

The rheumatologist will always be involved in the patient's care atlanta divorce attorneys treatment stage, by prescribing the DMARDs, deciding about surgery, referring to a occupational therapist, physiotherapist or dietician.


It is vital that the individual I fully alert to the treatment in case the surgery is offered as part of the treatment, the patient should be mentally active to comprehend the whole procedure for the joint replacement. There is no age limit as longer as the patient is understanding the procedure and the rehabilitation.




http://www. hopkins-arthritis. org/arthritis-info/rheumatoid-arthritis/rheum_clin_pres. html#epid

http://www. medicinenet. com/script/main/art. asp?articlekey=60768&page=7

http://arthritis. about. com/od/rheumatoidarthritis/a/RA_prognosis. htm?p=1

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