What is Rheumatoid arthritis?

Rheumatoid arthritis (RA) is an autoimmune disease where the body's immune system attacks normal joint tissues, causing inflammation of the joint lining.

This inflammation of the joint lining (called the synovium) can cause pain, stiffness, swelling, warmth, and redness. The affected joint may also lose its shape, resulting in loss of normal movement. RA is an ongoing disease, with active periods of pain and inflammation, known as flares, alternating with periods of remission, when pain and inflammation disappear.

RA can affect many different joints. In some people, it can even affect parts of the body other than the joints, including the eyes, blood, the lungs, and the heart.

Symptoms of Rheumatoid Arthritis

Although RA is often a chronic disease, the severity and duration of symptoms may unpredictably come and go. With RA, people experience periods of increased disease activity, called flare-ups or flares, alternating with periods when the symptoms fade or disappear, called remission.

If you experience some of these symptoms, you may want to talk to your doctor:

  • Pain and stiffness lasting for more than 1 hour in the morning or after a long rest
  • Joint inflammation in the joints closest to the hand, such as wrist and fingers, although the neck, shoulders, elbows, hips, knees, ankles, and feet can also be affected
  • Symmetrical pattern of inflammation, meaning both sides of the body are usually affected at the same time
  • Fatigue, an occasional fever, and a general sense of not feeling well (called malaise)

As RA progresses, about 25% of people with the disease develop small lumps of tissue under the skin, called rheumatoid nodules, which can vary in size. Usually, they are not painful.

If you are experiencing any of the symptoms described above, it is important to find out from a doctor if you have RA.

What causes rheumatoid arthritis?

The exact causes of RA are unknown. But research has shown that several factors may contribute to the development of RA:

  • Genetic. Certain genes play a role in the immune system — for some people, genetic factors may be involved in determining whether they will develop RA.
  • Environmental. In people who have inherited a genetic tendency for the disease, RA can be triggered by an infection. However, RA is not contagious — you can't "catch it" from anyone.

Effects of rheumatoid arthritis

Rheumatoid arthritis can cause joint inflammation, which can affect the ability to go about your daily activities. If left untreated, RA can worsen and destroy joints. After the onset of the disease, some of the effects of RA are as follows:

  • Tendons become inflamed and may rupture (tear apart).
  • Swelling can severely damage or destroy ligaments that hold joints together. It can also damage joint cartilage and bone.
  • Erosion of the bones of the joint can occur, causing pain and deformity.

Rheumatoid arthritis diagnosis

If you have persistent discomfort and swelling in multiple joints on both sides of your body, make an appointment to see your doctor. Early diagnosis and treatment can help slow disease progression.

When you see your doctor about your symptoms, he or she may ask questions about your medical history and examine the joints that are bothering you. Your doctor will also decide if you need other tests to help confirm the diagnosis of RA and determine the extent and severity of joint damage. These may include:

Blood Tests

  • One of the tests looks for an antibody called rheumatoid factor. About 70% to 90% of people with RA have this antibody. However, it is also possible to have the rheumatoid factor in your blood and not have RA.
  • Another test measures your erythrocyte sedimentation rate (or sed rate), which will indicate the presence of an inflammatory process in your body. People with RA tend to have abnormally high sed rates.

X-rays

  • X-rays of all your joints can determine the extent of damage in the joints that are affected. A sequence of X-rays obtained over time can show the progression of RA.

If you have joint pain, stiffness, and/or swelling that won't go away, you may have arthritis. Talk with your doctor about your symptoms.