Rheumatoid Arthritis Pdf

[Berniece Leonhardt]

Rheumatoidarthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels.

The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.

Ms. Williams: Dr. Nisha Manek says it happens when the immune system becomes deregulated. You see, the joint capsule has a lining of tissue called the synovium. The synovium makes fluid that keeps joints lubricated. When you have rheumatoid arthritis, your immune system sends antibodies to the synovium and causes inflammation. This causes pain and joint damage, especially in small joints in the fingers and wrists. But it can affect any joint.

Ms. Williams: Dr. Manek says if you have pain, swelling and stiffness in your joints that comes and goes and is on both sides of your body, see your doctor to see if it is rheumatoid arthritis.

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Rheumatoid arthritis is an autoimmune disease. Normally, your immune system helps protect your body from infection and disease. In rheumatoid arthritis, your immune system attacks healthy tissue in your joints. It can also cause medical problems with your heart, lungs, nerves, eyes and skin.

RA affects joints on both sides of the body, such as both hands, both wrists, or both knees. This symmetry helps to set it apart from other types of arthritis. Over time, RA can affect other body parts and systems, from your eyes to your heart, lungs, skin, blood vessels, and more.

This condition also is called juvenile idiopathic arthritis, or JIA. It causes swollen and stiff joints in children 16 or younger. If joint pain and stiffness last 6 weeks or longer, that may be JIA.

Systemic. About 10% of children with JIA get this type, which affects skin and internal organs as well as joints. Symptoms can include a fever above 103 F that lasts 2 weeks or more and a rash.

Psoriatic arthritis (PsA). This type affects joints and also causes a scaly rash. The rash often appears on the eyelids, knees, belly button, and scalp or behind the ears. Wrists, ankles, fingers, and toes are some of the joints that might be affected.

Enthesitis-related. Another name for this type is spondyloarthritis. It hits areas where muscles, ligaments, and tendons attach to bone. Hips, knees, and feet are the most common spots affected, but any joint can be involved. It also can affect the digestive tract. It's more common in boys and generally starts between the ages of 8 and 15.

Your joints might be tender and painful, even though you don't see redness or swelling. The first joints affected might be smaller ones, such as where your fingers attach to your hand and your toes to your feet.

RA can affect your skin as well as your joints. You might get firm lesions, called nodules, on your body. Another skin symptom is called vasculitis. One symptom of RA vasculitis is pits developing in your fingernails. Vasculitis also can cause a rash that might be raised or flat. It might look like bruises. The rash doesn't go away when you press on it. It often affects knees and lower legs.

Experts believe there are multiple genes that can make you vulnerable to RA. They estimate that if a family member has RA, your chances of inheriting it are about 60%. Researchers are looking at a number of genes, including those in the HLA Class II family.

Immune system cells move from the blood into your joints and the tissue that lines them. This tissue is called the synovium. Once the cells arrive, they create inflammation. This makes your joint swell as fluid builds up inside it. Your joints become painful, swollen, and warm to the touch.

Over time, the inflammation wears down the cartilage, a cushy layer of tissue that covers the ends of your bones. As you lose cartilage, the space between your bones narrows. As time goes on, they could rub against each other or move out of place. The cells that cause inflammation also make substances that damage your bones.

Early on, RA is hard to diagnose in part because it has symptoms in common with so many other conditions. There is no single test that shows whether you have RA. Your doctor will give you a checkup, ask you about your symptoms, and perform certain tests.

C-reactive protein (CRP). High levels of this substance are a sign of inflammation. Some people with rheumatoid arthritis also may have a positive antinuclear antibody test (ANA), which indicates an autoimmune disease, but the test does not specify which autoimmune disease.

Cyclic citrulline peptide antibody test (anti-CCP). This more specific test checks for anti-CCP antibodies, which suggest you might have a more aggressive form of rheumatoid arthritis.

Fish oil. These supplements might ease your pain and stiffness. If you take it, you might experience nausea, indigestion, and a fishy taste in your mouth. Fish oil can interfere with some medicines, so check with your doctor first.

Plant oils. Evening primrose, borage, and black currant contain substances that might reduce your pain and morning stiffness. Some people who take them get headaches and an upset stomach. These oils also can interfere with medication and may cause liver problems. Discuss with your doctor whether plant oils might benefit you.

Tai chi. This type of exercise focuses on gentle moves, stretches, and deep breathing. There's some evidence it can improve your quality of life with RA. If you're working with a qualified teacher, tai chi is safe. But don't do any moves that hurt.

Exercise. You can strengthen muscles around your affected joints with gentle exercise. It also may improve your fatigue. Check with your doctor before you start a workout program. Don't put stress on joints that are tender. Low-impact exercises to try include swimming, walking, cycling, and water aerobics.

Heat and ice. When you apply heat to an affected joint, it can ease pain and relax stiff muscles. When you apply cold to your joint, the numbing effect can dull your pain. Cold also can reduce swelling.

Sleep. You need your rest to help your body cope with RA. Limit caffeine late in the day, stay off electronic devices before bedtime, and make sure you take your medicine on schedule.

Changing what you eat may help with your RA symptoms. Adding healthy fats, and avoiding unhealthy fats and processed foods high in carbohydrates, can help reduce inflammation. You might also lose weight, which can ease stress on your joints. If you have RA, you're at higher risk of cardiovascular disease. Moving toward a heart-healthy diet can reduce your chances of heart disease.

Rheumatoid arthritis is an autoimmune disorder that can affect your joints as well as other parts of your body. When you have it, your joints become swollen, painful, and stiff. There's no cure for RA, but treatments can help relieve your symptoms. Lifestyle changes, such as altering your diet, getting plenty of rest, and low-impact exercise, also may ease the effects of RA.

Rheumatoid arthritis (RA) is a chronic (long-lasting) autoimmune disease that mostly affects joints. RA occurs when the immune system, which normally helps protect the body from infection and disease, attacks its own tissues. The disease causes pain, swelling, stiffness, and loss of function in joints.

RA affects people differently. In some people, RA starts with mild or moderate inflammation affecting just a few joints. However, if it is not treated or the treatments are not working, RA can worsen and affect more joints. This can lead to more damage and disability.

Rheumatoid arthritis can happen in any joint; however, it is more common in the wrists, hands, and feet. The symptoms often happen on both sides of the body, in a symmetrical pattern. For example, if you have RA in the right hand, you may also have it in the left hand.

Many people with RA get very tired (fatigue) and some may have a low-grade fever. RA symptoms may come and go. Having a lot of inflammation and other symptoms is called a flare. A flare can last for days or months.

Getting an accurate diagnosis as soon as possible is the first step to treating RA effectively. A doctor with specialized training in treating arthritis (called a rheumatologist) is the best person to make a correct diagnosis, using medical history, a physical examination and lab tests.

Medical history. The doctor will ask about joint symptoms (pain, tenderness, stiffness, difficulty moving), when they started, if they come and go, how severe they are, what actions make them better or worse and whether family members have RA or another autoimmune disease.

Physical examination. The doctor will look for joint tenderness, swelling, warmth and painful or limited movement, bumps under the skin or a low-grade fever.

Blood tests. The blood tests look for inflammation and blood proteins (antibodies) that are linked to RA:

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