Putting Orthopaedic Pieces Together: A Joint Effort
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What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the joints but can also involve other body systems. Unlike osteoarthritis, which is often associated with wear and tear on the joints, rheumatoid arthritis is characterized by the immune system mistakenly attacking the synovium, the lining of the membranes that surround the joints. This autoimmune response leads to joint inflammation, pain, and potentially joint damage. Here’s a detailed explanation of rheumatoid arthritis:


Key Features and Causes:

  • Autoimmune Disease: RA is considered an autoimmune disorder, meaning the immune system, which normally protects the body from infections, mistakenly targets the body’s own tissues, especially the synovium.


  • Chronic Inflammation: The autoimmune response triggers chronic inflammation in the synovium, leading to joint swelling, pain, and damage over time.


  • Unknown Cause: The exact cause of RA is not fully understood, but it likely involves a combination of genetic, environmental, and hormonal factors. Smoking is a known risk factor for RA.



  • Joint Pain and Stiffness: RA typically presents with joint pain, swelling, and stiffness, often worse in the morning or after periods of inactivity.


  • Symmetrical Joint Involvement: RA often affects joints on both sides of the body simultaneously (e.g., both wrists or both knees).


  • Fatigue: Many individuals with RA experience fatigue, which can be debilitating.


  • Joint Deformities: Over time, RA can lead to joint deformities and loss of joint function.


  • Systemic Effects: RA can affect other body systems, leading to complications such as inflammation in the eyes, lungs, heart, and blood vessels.



  • Clinical Evaluation: Diagnosis is based on a combination of clinical evaluation, medical history, physical examination, and laboratory tests.


  • Blood Tests: Specific blood tests, such as rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies, are often used to support the diagnosis.



  • Disease-Modifying Antirheumatic Drugs (DMARDs): DMARDs are the cornerstone of RA treatment. These medications, including methotrexate, hydroxychloroquine, and biologic agents, help control the autoimmune response and reduce joint inflammation.


  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs can provide relief from pain and inflammation.


  • Corticosteroids: These anti-inflammatory medications may be prescribed in the short term to manage acute symptoms.


  • Physical Therapy: Physical therapy and regular exercise help improve joint function and maintain mobility.


  • Joint Protection: Occupational therapy can teach strategies to protect joints during daily activities.


  • Surgery: In severe cases with joint damage, joint replacement surgery may be considered.



  • The course of RA varies among individuals. Some experience mild symptoms, while others may have severe joint damage and functional limitations.


  • Early diagnosis and prompt treatment are crucial in managing RA and preventing joint damage.


  • Regular follow-up with a rheumatologist is essential to monitor disease activity and adjust treatment as needed.


Rheumatoid arthritis is a chronic condition that requires ongoing management. While there is no cure, current treatment options aim to control symptoms, slow disease progression, and improve the quality of life for individuals with RA.