What is Rheumatoid Arthritis? There are many different types of arthritis. Certainly one of the most serious ones is rheumatoid arthritis. This is a chronic , systemic (thru the whole body), inflammatory (red, hot, tender joints) disorder of unclear cause. This arthritis is symmetrical. If the disease is not controlled, the joints may be destroyed and/or become disfigured which leads to disability.
How is it diagnosed? Here is a summary of the characteristic features used to make the diagnosis: morning stiffness for at least one hour and present for at least six weeks; swelling of three or more joints for at least six weeks; swelling of the wrist or hand joints for at least six weeks; hand x-rays that show erosions in a joint; nodules under the skin; or blood tests that are positive for rheumatoid factor or other markers of inflammation.
A real key is morning stiffness associated with fatigue, weight loss, low grade fever and depression. These are very common presentations. It can also be a cause of carpal tunnel syndrome.
What does it affect? At presentation, one joint (such as hand) or many may be involved. Key is how the arthritis has affected daily activities such as walking, doing stairs, dressing, use of the toilet, getting up from a chair, opening jars, opening doors, typing, or performing on the job. The feet may also be involved. A very potential and serious involvement would be the upper cervical neck. If you have been diagnosed with rheumatoid arthritis (RA), ask your doctor about getting x-rays of your upper neck.
It is important to know that rheumatoid arthritis may affect other systems outside of the joints. Anemia, skin, heart, nerves( neuropathy), eyes, spleen, blood vessels(vasculitis) may all be involved. These other systems almost always occur with the joints.
Most patients show a fluctuation of disease activity (changes in symptoms) over a period of months. The goal is remission (symptoms of disease subside) which is very rare without the use medication called disease modifying anti rheumatic drugs( DMARDS). We do see some remissions here in the clinic.
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