What is it?
Rheumatoid arthritis (RA) is a long-term condition that usually affects joints: hand and wrists most commonly, but also elbows, neck, shoulders, hips, knees, and feet. RA causes swelling, stiffness, pain, and loss of function in the joints. Other symptoms include fatigue, fever, and a sense of not feeling well (malaise). Many people with RA develop anaemia. RA also increases the risk of thinning of the bones, osteoporosis, particularly in those taking corticosteroid drugs such as prednisone. The disease can affect other body organs as well, causing dry eyes and mouth - symptoms of Sjögren’s syndrome.
Rheumatoid arthritis usually develops slowly between the ages of 20 and 45. More than 75% of patients are women. RA is different from osteoarthritis, in which joint tissue wears down from repetitive use or age. RA usually affects joints in a symmetrical way. If one knee is affected, the other knee is also affected. The disease may be partly inherited through genes, but other factors are probably at work, including some kind of a trigger for the gene, such as an infection. The disease is not contagious, however. Some scientists also think that changes in certain hormones may promote RA in people with particular genes who have been exposed to the triggering agent.
Rheumatoid arthritis is diagnosed from your signs and symptoms. The diagnosis can be supported with a blood test for an antibody known as rheumatoid factor (RF). The RF test for the presence of the RF antibody in blood is positive in about 80% of people with RA. However, this test is also positive about 5% of people without the disease. Another antibody test known as the cyclic citrullinated peptide (CCP) has more recently become available and can help doctors make a diagnosis in difficult cases.
Other common tests to support a diagnosis of RA and to monitor treatment for it include:
- Erythrocyte sedimentation rate (ESR) which is a measure of inflammation and the activity of the disease
- C-reactive protein test (CRP) which also indicates inflammation and the activity of the disease
- Full blood count (FBC) - about 80% of people with RA develop anaemia detected by a FBC
- X-ray imaging and MRI might also be used to look at particular joints in more detail
Several different types of medication are used to treat RA, including pain relievers, non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs, immunosuppressants, and corticosteroids (also known as glucocorticoids). People with RA can also make beneficial lifestyle changes such as exercises, better diets, resting, avoiding stress, and taking special care of joints with well-designed devices that are easy on joints. Surgery is occasionally used for some patients with severe joint involvement.