Rheumatoid arthritis (patient information)

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Rheumatoid arthritis

Overview

What are the symptoms?

Who is at highest risk?

When to seek urgent medical care?

Diagnosis

Treatment options

Where to find medical care for rheumatoid arthritis?

Prevention of rheumatoid arthritis

What to expect (Outlook/Prognosis)?

Possible Complications

Rheumatoid arthritis On the Web

Ongoing Trials at Clinical Trials.gov

Images

US National Guidelines Clearinghouse

NICE Guidance

FDA on Rheumatoid arthritis

CDC on Rheumatoid arthritis

Rheumatoid arthritis in the news

Blogs on Rheumatoid arthritis

Directions to Hospitals Treating Rheumatoid arthritis

Risk calculators and risk factors for Rheumatoid arthritis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

Overview

Rheumatoid is an autoimmune disease that typically affects the small joints in your hands and feet. The cause is not clear. When the disease is active,usual signs and symptoms include morning stiffness, joint pain and swelling, rheumatoid nodules, fatigue and weakness, low fever, and weight loss. Blood tests on rheumatoid factor, anti-cyclic citrullinated peptide (anti-CCP) and antinuclear antibody (ANA) can not only help diagnose but also help assess prognosis. Joint images such as x-ray and MRI may help track the progression of rheumatoid arthritis in the joints over time. Treatment opinion includes medications, physical therapy and surgery. The opinion depends on the diesease condition. Prognosis of rheumatoid arthritis varies from person to person. Some patients may get less aggressive over time, while others may lose their abilities of doing daily tasks.

Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

This is a gross photograph of the patient's hands at autopsy. Note the swollen joints and the deforming arthritis.


This is a gross photograph of the foot from this same patient. Note the subcutaneous nodule on the medial aspect of the foot (arrow).


What are the symptoms?

Affected joints of rheumatoid arthritis include the fingers, wrists, elbows, shoulders, hips, knees, ankles, toes, jaw, and neck. Signs and symptoms come and go, depending on the degree of tissue inflammation. When the disease is active, the following symptoms appear.

Who is at highest risk?

As an autoimmune disease, the cause of rheumatoid arthritis is not clear.

When to seek urgent medical care?

Call your doctor if your symptoms of rheumatoid arthritis progress.

Diseases that can present with similar symptoms are

Diagnosis

To come to a proper diagnosis, your doctor might run the following test

  • Blood tests: These tests can assist in making a diagnosis of rheumatic arthritis.
  • Synovial fluid examination: When a patient demonstrates the signs of acute inflammatory arthritis, it is necessary to aspirate synovial fluid of the involved joint to rule out infectious arthritis. During the procedure, the doctor may use a needle to draw fluid from your affected joint. Based on the discovery of urate crystals in the synovial fluid or soft tissues, the doctors can confirm the diagnosis.
  • Joint x-ray: This image can help track the progression of rheumatoid arthritis in the joints over time.
  • Magnetic resonance imaging (MRI): An MRI uses magnetic fields but it is a different type of image than what is produced by computed tomography (CT) and produces detailed images of the joint.

Treatment options

There is no cure for rheumatoid arthritis. Treatment opinion includes medications, physical therapy and surgery. The opinion depends on the diesease condition.

  • Medications: The goal of medications can reduce inflammation to relieve pain and prevent or slow joint damage.
  • Physical therapy: The aim of physical therapy is to teach you how to protect the joints. The therapist can treat you by hands or by assistive devices. Common therapies include:
  • Range-of-motion exercises
  • Joint protection techniques
  • Heat and cold treatments
  • Deep heat or electrical stimulation treatments
  • Surgery: If medications fail to prevent or slow joint damage, surgery may be recommended to repair damaged joints and restore your ability to use the joints. Surgeries on rheumatoid arthritis include:

Where to find medical care for rheumatoid arthritis?

Directions to Hospitals Treating rheumatoid arthritis

Prevention of rheumatoid arthritis

The cause of rheumatoid arthritis is not clear, therefore prevention of the disease is unknown.

What to expect (Outlook/Prognosis)?

Prognosis of rheumatoid arthritis varies from person to person. Disease may get less aggressive over time in some patients. In other group, patients may lose their abilities of doing daily tasks. Prognosis depends on:

  • Whether the patient shows rheumatoid nodules or not: Patients with subcutaneous nodules seem to have a more severe form of the disease.
  • Rheumatoid factor, anti-CCP antibody test: Patients with positive outcomes of rheumatoid factor, the anti-CCP antibody may have a worse outlook than those who have a negative outcomes.
  • Tha age of developing rheumatoid arthritis: If the patient develops rheumatoid arthritis at younger age, the prognosis seems poor.

Possible Complications

Complication of rheumatoid arthritis involve all the systems. Cardiac complications are pericarditis, congestive heart failure, endocarditis and myocardial infarction. Pulmonary complications are pleurisy, alveolitis, pleural effusion and pulmonary fibrosis. Rheumatological complications are joint deformities, felty's syndrome, sjögren's syndrome, osteoporosis and atlantoaxial subluxation. Eye complications such as scleritis and keratitis. Renal complications are chronic renal failure from amyloidosis. Nervous system complications like peripheral neuropathy and mononeuritis multiplex.

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/000431.htm

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