Thursday, October 20, 2011

Rheumatoid Arthritis


Rheumatoid arthritis is a chronic inflammatory disorder that most typically affects the small joints in your hands and feet. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.

An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. In addition to causing joint problems, rheumatoid arthritis can also affect your whole body with fevers and fatigue.
Rheumatoid arthritis is two to three times more common in women than in men and generally occurs between the ages of 40 and 60. While there's no cure for rheumatoid arthritis, treatment options have expanded greatly in the past few decades.
Rheumatoid arthritis is a chronic inflammatory disorder that most typically affects the small joints in your hands and feet. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.
An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. In addition to causing joint problems, rheumatoid arthritis can also affect your whole body with fevers and fatigue.
Rheumatoid arthritis is two to three times more common in women than in men and generally occurs between the ages of 40 and 60. While there's no cure for rheumatoid arthritis, treatment options have expanded greatly in the past few decades.
Signs and symptoms of rheumatoid arthritis may include:
·         Joint pain
·         Joint swelling
·         Joints that are tender to the touch
·         Red and puffy hands
·         Firm bumps of tissue under the skin on your arms (rheumatoid nodules)
·         Fatigue
·         Morning stiffness that may last for hours
·         Fever
·         Weight loss
Smaller joints affected first
Early rheumatoid arthritis tends to affect your smaller joints first — the joints in your wrists, hands, ankles and feet. As the disease progresses, your shoulders, elbows, knees, hips, jaw and neck also can become involved. In most cases, symptoms occur symmetrically — in the same joints on both sides of your body.
Symptoms may come and go
Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity — called flare-ups or flares — alternate with periods of relative remission, during which the swelling, pain, difficulty sleeping and weakness fade or disappear.
When to see a doctor
Make an appointment with your doctor if you have persistent discomfort and swelling in multiple joints on both sides of your body.
Rheumatoid arthritis occurs when your immune system attacks the synovium, the lining of the membranes that surround your joints. The resulting inflammation thickens the synovium, which can eventually invade and destroy the cartilage and bone within the joint. The tendons and ligaments that hold the joint together weaken and stretch. Gradually, the joint loses its shape and alignment.
Doctors don't know what starts this process, although a genetic component appears likely. While your genes don't actually cause rheumatoid arthritis, they can make you more susceptible to environmental factors — such as infection with certain viruses and bacteria — that may trigger the disease.
Factors that may increase your risk of rheumatoid arthritis include:
·         Sex. Women are more likely to develop rheumatoid arthritis than men are.
·         Age. Rheumatoid arthritis can occur at any age, but it most commonly begins between the ages of 40 and 60.
·         Family history. If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease. Doctors don't believe you can directly inherit rheumatoid arthritis. Instead, it's believed that you can inherit a predisposition to rheumatoid arthritis.
·         Smoking. Smoking cigarettes increases your risk of rheumatoid arthritis. Quitting can reduce your risk.
Rheumatoid arthritis causes joint damage that can be both debilitating and disfiguring. Damage to your joints may make it difficult or impossible to go about your daily activities. You may find at first that tasks take more energy to accomplish. With time you may find you are no longer able to do them at all. Newer treatments may stop joint damage or prevent it so that you can continue the activities you enjoy.
In addition to the physical exam, your doctor might order imaging and laboratory tests to help determine the cause of your signs and symptoms. Rheumatoid arthritis can be difficult to diagnose in its early stages because its early signs and symptoms mimic those of many other diseases. And no one test or physical finding confirms the diagnosis.
Blood tests
People with rheumatoid arthritis tend to have an elevated erythrocyte sedimentation rate (ESR, or sed rate), which indicates the presence of an inflammatory process in the body. Other common blood tests look for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies.
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