RHEUMATOID ARTHRITIS

Rheumatoid arthritis

Rheumatoid arthritis

Rheumatoid arthritis is a chronic disease that is characterized by stiffness, swelling, pain, and loss of motion in the joints. It is primarily characterized by inflammation of the synovium (or lining) of the joints and can lead to long-term joint damage, resulting in chronic pain, loss of function, and significant disability. Although it most commonly affects the joints, it can affect other parts of the body as well. Approximately 0.8 percent of the adult population worldwide is affected with rheumatoid arthritis. Rheumatoid arthritis can affect children, but onset usually occurs between 30 and 50 years of age. It is approximately three times more common in women than men. Over 250,000 hospitalizations and 9 million physician visits per year are attributed to rheumatoid arthritis.

CAUSES

The cause of this disease is currently unknown. There are many factors that are thought to play a role in rheumatoid arthritis. There does appear to be a genetic (or inherited) component to the disease. Researchers have discovered that certain genes are associated with the development of rheumatoid arthritis. However, the presence of these genes is not predictive of who will have the disease. Some people with rheumatoid arthritis do have not these genes and some people who have the genes do not ever develop rheumatoid arthritis. There are other factors that are theorized to increase risk for rheumatoid arthritis. Some researchers believe that something like a viral or bacterial infection can act as a trigger to initiate the disease process. Other researchers believe that there are certain hormonal factors that may be involved. As mentioned above, women are approximately three times more likely to get rheumatoid arthritis than men. Typically, the disease will go into remission during pregnancy, but have an increase in symptoms after the baby is born. In addition, women develop rheumatoid arthritis more often in the first year after pregnancy than would be expected in the general population. This has led some researchers to postulate that sex may be one determinant of the development of rheumatoid arthritis. Currently, there are few answers to these questions.

DIAGNOSIS

In the early stages of the disease, rheumatoid arthritis can be difficult to diagnose for several reasons. First, often only a few symptoms may be present at the early stages of the disease. It may take time for the full range of symptoms to develop. Also, symptoms at the onset of the disease can vary widely from person to person. Some people have more severe symptoms than others. In addition, some symptoms are very similar to those experienced by persons with other types of joint conditions or arthritis. It may take some time to rule out the other causes of the symptoms. Further complicating the diagnosis is that there is no one specific test that will determine if a person has rheumatoid arthritis. Because of these factors, a variety of tools are used to diagnose rheumatoid arthritis and to rule out other conditions.

Initial assessment of the patient will begin with a thorough medical ...