A chronic inflammatory disease that primarily affects the
joints and surrounding tissues, but can also affect other
incidence, and risk factors
The cause of rheumatoid arthritis (RA) is unknown, however
the condition involves an attack on the body by its own immune
cells (auto-immune disease). Different cases may have different
causes. Infectious, genetic, and hormonal factors may play
can occur at any age, but the peak incidence of disease onset
is between the ages of 25 and 55. The disease is more common
in older people. Women are affected 2.5 times more often than
men. Approximately 1-2percent of the total population is affected.
The course and the severity of the illness can vary considerably.
of the disease is usually gradual, with fatigue, morning stiffness
(lasting more than one hour), diffuse muscular aches, loss
of appetite and weakness. Eventually, joint pain appears,
with warmth, swelling, tenderness, and stiffness of the joint
involvement in RA usually affects both sides of the body equally
-- the arthritis is therefore referred to as symmetrical.
Wrists, fingers, knees, feet and ankles are the most commonly
affected joints. Severe disease is associated with larger
joints that contain more synovium (joint lining).
synovium becomes inflamed, it secretes more fluid and the
joint becomes swollen. Later, the cartilage becomes rough
and pitted. The underlying bone eventually becomes affected.
Joint destruction begins 1-2 years after the appearance of
deformities result from cartilage destruction, bone erosions,
and tendon inflammation and rupture. A life-threatening joint
complication can occur when the cervical spine becomes unstable
as a result of RA.
features of the disease that do not involve the joints may
occur. Rheumatoid nodules are painless, hard, round or oval
masses that appear under the skin, usually on pressure points,
such as the elbow or Achilles tendon. These are present in
about 20 percent of cases and tend to reflect more severe
they appear in the eye where they sometimes cause inflammation.
If they occur in the lungs, inflammation of the lining of
the lung (pleurisy) may occur, causing shortness of breath.
may occur due to failure of the bone marrow to produce enough
new red cells to make up for the lost ones. Iron supplements
will not usually help this condition because iron utilisation
in the body becomes impaired. Other blood abnormalities can
also be found, for example, platelet counts that are either
too high or too low.
vasculitis (inflammation of the blood vessels) is a serious
complication of RA and can be life-threatening. It can lead
to skin ulcerations (and subsequent infections), bleeding
stomach ulcers (which can lead to massive hemorrhage), and
neuropathies (nerve problems causing pain, numbness or tingling).
may also affect the brain, nerves, and heart causing strokes,
sensory neuropathies (numbness and tingling), heart attacks,
or heart failure.
complications of RA commonly affect the outer lining of the
heart. When inflamed, the condition is referred to as pericarditis.
Inflammation of heart muscle, called myocarditis, can also
develop. Both of these conditions can lead to congestive heart
failure characterised by shortness of breath and fluid accumulation
in the lung.
is frequent in RA. Fibrosis of the lung tissue leads to shortness
of breath and has been reported to occur in 20 percent of
patients with RA. Inflammation of the lining of the lung,
called pleuritis, can also lead to fluid accumulation. Pulmonary
nodules, similar to rheumatoid nodules, can also develop.
include inflammation of various parts of the eye. These must
be screened for in RA patients.
Rheumatoid arthritis has no known prevention. However, it
is often possible to prevent further damage of the joints
with proper early treatment.
*General discomfort, uneasiness, or malaise
*Loss of appetite
*Joint pain, joint stiffness, and joint swelling
*May involve wrist pain, knee pain, elbow pain, finger pain,
toe pain, ankle pain, or neck pain
*Limited range of motion
*Morning stiffness lasting more than one hour
*Deformities of hands and feet
*Round, painless nodules under the skin
*Skin redness or inflammation
*Eye burning, itching, and discharge
*Numbness and/or tingling
(R) thedailystar.net 2005