Rheumatoid arthritis
Type of autoimmune arthritis / From Wikipedia, the free encyclopedia
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Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints.[1] It typically results in warm, swollen, and painful joints.[1] Pain and stiffness often worsen following rest.[1] Most commonly, the wrist and hands are involved, with the same joints typically involved on both sides of the body.[1] The disease may also affect other parts of the body, including skin, eyes, lungs, heart, nerves, and blood.[1] This may result in a low red blood cell count, inflammation around the lungs, and inflammation around the heart.[1] Fever and low energy may also be present.[1] Often, symptoms come on gradually over weeks to months.[2]
Rheumatoid arthritis | |
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A hand severely affected by rheumatoid arthritis. This degree of swelling and deformation does not typically occur with current treatment. | |
Specialty | Rheumatology, Immunology |
Symptoms | Warm, swollen, painful joints[1] |
Complications | Low red blood cells, inflammation around the lungs, inflammation around the heart[1] |
Usual onset | Middle age[1] |
Duration | Lifelong[1] |
Causes | Unknown[1] |
Diagnostic method | Based on symptoms, medical imaging, blood tests[1][2] |
Differential diagnosis | Systemic lupus erythematosus, psoriatic arthritis, fibromyalgia[2] |
Medication | Pain medications, steroids, Nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs[1] |
Frequency | 0.5–1% (adults in developed world)[3] |
Deaths | 30,000 (2015)[4] |
While the cause of rheumatoid arthritis is not clear, it is believed to involve a combination of genetic and environmental factors.[1] The underlying mechanism involves the body's immune system attacking the joints.[1] This results in inflammation and thickening of the joint capsule.[1] It also affects the underlying bone and cartilage.[1] The diagnosis is made mostly on the basis of a person's signs and symptoms.[2] X-rays and laboratory testing may support a diagnosis or exclude other diseases with similar symptoms.[1] Other diseases that may present similarly include systemic lupus erythematosus, psoriatic arthritis, and fibromyalgia among others.[2]
The goals of treatment are to reduce pain, decrease inflammation, and improve a person's overall functioning.[5] This may be helped by balancing rest and exercise, the use of splints and braces, or the use of assistive devices.[1][6][7] Pain medications, steroids, and NSAIDs are frequently used to help with symptoms.[1] Disease-modifying antirheumatic drugs (DMARDs), such as hydroxychloroquine and methotrexate, may be used to try to slow the progression of disease.[1] Biological DMARDs may be used when the disease does not respond to other treatments.[8] However, they may have a greater rate of adverse effects.[9] Surgery to repair, replace, or fuse joints may help in certain situations.[1]
RA affects about 24.5 million people as of 2015.[10] This is 0.5–1% of adults in the developed world with between 5 and 50 per 100,000 people newly developing the condition each year.[3] Onset is most frequent during middle age and women are affected 2.5 times as frequently as men.[1] It resulted in 38,000 deaths in 2013, up from 28,000 deaths in 1990.[11] The first recognized description of RA was made in 1800 by Dr. Augustin Jacob Landré-Beauvais (1772–1840) of Paris.[12] The term rheumatoid arthritis is based on the Greek for watery and inflamed joints.[13]