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Rheumatoid Arthritis - Symptoms, Causes, Risk factors and Treatment

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Rheumatoid arthritis, or RA, is an autoimmune and inflammatory disease, which means that immune system attacks own healthy cells in the body by mistake. Causing inflammation, pain and swelling of affecting body parts.
Rheumatoid Arthritis mainly attacks the joints, usually many joints at once.
Common joints affected are: joints in the hands, wrists, and knees.
Joint with Rheumatoid Arthritis becomes inflamed. Inflammation further damages joint tissue, which can cause long-lasting or chronic pain, unsteadiness (lack of balance), and deformity (misshapenness).

Rheumatoid Arthritis can also affect other parts of the body, and cause problems in organs such as the lungs, heart, and eyes.
Signs and Symptoms:
The most common and predominant symptoms include joint pain and stiffness, especially morning stiffness and swelling.
Usually, the onset of symptoms is slow and insidious.
There are times when symptoms get worse, known as flares, and times when symptoms get better, known as remission.
Main signs and symptoms include:
Pain or aching in more than one joint, Stiffness in more than one joint, Swelling in more than one joint,
The same symptoms on both sides of the body (such as in both hands or both knees).
On physical examination, the affected joint will be painful if pressure is applied to the joint or on movement with or without joint swelling. Synovial thickening with a "boggy" feel on palpation will be noted.
Rheumatoid nodules are the most common cutaneous manifestations of Rheumatoid arthritis.
Vasculitis involving both medium and small-sized blood vessels can also be seen as a presenting symptom of Rheumatoid Arthritis. However, the prevalence of vasculitis among patients with RA is low.
Sometimes: Weight loss, Fever, Fatigue or tiredness and weakness
There are some Risk Factors identified for developing rheumatoid arthritis. :
Age – the like hood of rheumatoid arthritis increases with age. Most common age is six decade of life.
Rheumatoid arthritis is much more common among women, then men.
Genetics play some role.
Smoking and obesity are additional risk factors.
Women who have never given birth may be at greater risk of developing Rheumatoid Arthritis.
Characteristics that can decrease risk:
Breastfeeding. Women who have breastfed their infants have a decreased risk of developing RA.
Among modifiable risk factors, cigarette smoking has the strongest association with RA. Diet and nutrition have been shown to play a significant role as environmental triggers for RA. The typical 'western' diet that is rich, high in caloric content, and low in fiber increases the risk of RA. Consumption of long-chain omega-3 polyunsaturated fatty acids is associated with a reduced risk of RA.

Diagnosis:
Rheumatoid Arthritis is diagnosed by symptoms, physical examination, and doing X-rays.
Early diagnosis have best prognosis. Early diagnosis is considered within 6 months of the onset of symptoms.
Laboratory testing usually reveals anemia of chronic disease and thrombocytosis. Neutropenia may be present if Felty syndrome is present. About 75% to 85% of patients with RA will test positive for rheumatoid factor (RF), ACPA, or both.
However, the presence of rheumatoid factor is not diagnostic of rheumatoid arthritis. It may be present in other connective tissue diseases, chronic infections, and healthy individuals.
Acute phase reactants, such as erythrocyte sedimentation rate (ESR) and levels of C-reactive protein (CRP), are usually elevated in patients with active disease and should be obtained.
With advanced disease, joint involvement on plain radiographs will reveal periarticular osteopenia, joint space narrowing, and bony erosions. Erosions of cartilage and bone are considered pathognomonic findings


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