Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that primarily affects the joints, causing pain, swelling, stiffness, and progressive joint damage. It is characterized by inflammation of the synovium, the tissue that lines the joints, leading to joint destruction and potentially resulting in disability if left untreated. Here's an overview of rheumatoid arthritis:

Pathophysiology: In rheumatoid arthritis, the immune system mistakenly attacks the body's own tissues, particularly the synovium, which becomes inflamed and thickened. This inflammation leads to the release of enzymes that break down cartilage and bone within the joint, causing pain, swelling, and joint deformity over time. Chronic inflammation can also affect other organs and systems in the body, leading to systemic complications.

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Symptoms:

• Joint Pain: Pain and stiffness, often worse in the morning or after periods of inactivity, are common symptoms of RA. Joints affected by RA are typically swollen, tender, and warm to the touch.

• Joint Swelling: Inflammation of the synovium leads to swelling and fluid accumulation in the affected joints.

• Joint Stiffness: Stiffness, particularly in the morning or after prolonged rest, is a hallmark symptom of RA. Joint stiffness may improve with movement but tends to persist throughout the day as the disease progresses.

• Fatigue: Many people with RA experience persistent fatigue, which can significantly impact daily activities and quality of life.

• Systemic Symptoms: RA can affect other organs and systems in the body, leading to symptoms such as fever, weight loss, dry eyes, dry mouth, and skin nodules.

 

Risk Factors:

• Genetic Factors: Certain genetic variations are associated with an increased risk of developing RA, although genetics alone do not determine disease risk.

• Environmental Factors: Environmental factors such as smoking, infections, and exposure to certain pollutants or toxins may contribute to the development of RA in genetically susceptible individuals.

• Hormonal Factors: RA is more common in women than in men, suggesting a role for hormonal factors in disease susceptibility and progression.

• Age: Although RA can occur at any age, it most commonly affects adults between the ages of 30 and 60.

 

Diagnosis: Diagnosing RA involves a combination of medical history, physical examination, laboratory tests, and imaging studies. Key diagnostic criteria include:

• Symmetrical joint involvement

• Morning stiffness lasting more than 30 minutes

• Presence of rheumatoid nodules

• Positive blood tests for rheumatoid factor (RF) and/or anti-cyclic citrullinated peptide (anti-CCP) antibodies

• Evidence of joint inflammation on imaging studies such as X-rays or ultrasound

 

Treatment: Treatment for rheumatoid arthritis aims to reduce inflammation, relieve symptoms, prevent joint damage, and improve overall function and quality of life. Treatment options may include:

• Acupuncture:  Acupuncture offers relief from pain and inflammation associated with rheumatoid arthritis.

• Disease-Modifying Antirheumatic Drugs (DMARDs): DMARDs such as methotrexate, hydroxychloroquine, sulfasalazine, and biologic therapies are used to suppress inflammation and slow the progression of joint damage.

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs such as ibuprofen, naproxen, and celecoxib can help reduce pain and inflammation.

• Corticosteroids: Oral or injectable corticosteroids may be used to quickly reduce inflammation during flare-ups.

• Physical Therapy: Exercise, stretching, and physical therapy techniques can help improve joint flexibility, strength, and function.

• Lifestyle Modifications: Adopting a healthy lifestyle, including regular exercise, maintaining a healthy weight, and avoiding smoking, can help manage symptoms and improve overall health.

• Surgery: In severe cases of RA with joint damage and disability, surgical interventions such as joint replacement surgery (arthroplasty) may be necessary to restore function and relieve pain.