Rheumatoid arthritis (RA) is a chronic, polyarticular, and systemic autoimmune disease. This means it occurs because the immune system—which normally defends the body against harmful agents—cannot distinguish between the body’s own tissues and foreign substances, and it attacks the body’s own tissues. In RA, the synovial membrane, which lines the inside of a joint capsule and produces synovial fluid, is primarily affected.
RA mainly affects the small joints, such as those between the phalanges of the fingers, and usually occurs symmetrically, affecting the same joints on both sides of the body. It can affect people of all ages, though its incidence increases with age, and women are twice as likely to be affected as men. The exact cause is not fully known, but genetics appear to play a significant role.
The onset of RA is usually insidious and nonspecific, with morning stiffness and pain in the fingers and toes. Patients often have difficulty performing fine motor tasks, such as tying shoelaces, especially in the morning.
As the disease progresses, especially if untreated, joints become swollen due to inflammation, fingers weaken, and the overlaying skin may become red and warm. In advanced stages, joints can become severely deformed and lose full functionality, meanwhile, muscles, tendons, and ligaments around the joints are often affected.
Quite often soft nodules, called rheumatoid nodules, appear over affected joints. In some patients, RA may also affect other parts of the body, leading to complications in the nervous, gastrointestinal, respiratory, cardiovascular, urinary systems, and eyes.
Patients with systemic involvement have a higher risk of life-threatening complications than those with joint-only involvement.
Diagnosis is usually based on the patient’s clinical presentation and medical history, as there are no specific findings in plain X-rays or in histological examination of synovial tissue or fluid. However, in some cases, the rheumatoid factor—detected in a simple blood test—may be elevated. Other blood test findings can include Increased CRP and ESR, anemia, elevated platelet or eosinophil count.
Significant progress has been made in recent years in treating the disease’s inflammation, pain, and symptoms. As well as traditionally used antirheumatoid medications, such as methotrexate, corticosteroids and analgesics, in recent years biological factors have been added to the medical treatment’s arsenal. These factors prove to significantly delay the joint decay and the appearance of kinetic disability.
When medical treatment is not enough to relieve the pain, intra-articular corticosteroid injection and analgesics can bear significant results. In cases with severely limited joint function and mobility, an inflamed joint capsule can be surgically removed or the entire joint can be replaced through arthroplasty.
However, it is important to emphasize that the highest success rates of any method are observed in patients who are regularly monitored, so that the progression of the condition can be checked and the necessary therapeutic adjustments can be made.
Moreover, with advances in technology, a wide range of products has become available to the general public, specifically designed to facilitate daily life for those affected, such as specially designed shoes or braces to immobilize the joints and better control pain.
