1. All About Rheumatoid Arthritis

2. The Facts About Rheumatoid Arthritis
Most common form of inflammatory arthritis.
Affecting about two to three million Americans.
Higher rate among woman.
Onset is usually between 25 yrs. and 50 yrs., but can occur in children and senior citizens.
Attacks the lining of the joint
Source
Dynomed, Inc. “What is Rheumatoid Arthritis”. DePuy Orthopaedics, Inc. 2 April,
Notes
Rheumatoid arthritis is the most common form of inflammatory arthritis, affecting about two to three million Americans.  Most often it first appears between the ages of 25 and 50 but it can occur in children and in senior citizens. Three quarters of all people with this disease are women.
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3. What is Rheumatoid Arthritis?
Chronic disease; last a long time and can have a series of flare-ups and remissions.
Symmetric disease; it will usually affect the same joints on both sides of the body.
Inflammation in the lining of the joints and/or other internal organs.
Most commonly affected joints are the fingers, wrists, arms, spine and legs.
Source
“Rheumatoid Arthritis”.Arthritis Foundation. 2 April,
Notes
What Is It?
Rheumatoid arthritis (rue-ma-TOYD arth-write-tis) involves inflammation in the lining of the joints and/or other internal organs. RA typically affects many different joints. It is typically chronic, which means it lasts a long time, and can be a disease of flare-ups.
RA is a systemic disease that affects the entire body and is one of the most common forms of arthritis. It is characterized by the inflammation of the membrane lining the joint, which causes pain, stiffness, warmth, redness and swelling. The inflamed joint lining, the synovium, can invade and damage bone and cartilage. Inflammatory cells release enzymes that may digest bone and cartilage. The involved joint can lose its shape and alignment, resulting in pain and loss of movement.
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4. Symptoms of Rheumatoid Arthritis
Swelling, pain, and stiffness in the joint, even when not in use.
Overall stiffness in the morning and after inactivity.
Systemic symptoms including:
fever
anemia (low red blood cell count)
loss of appetite
fatigue
Possible rheumatoid nodules (lumps of tissue under the skin)
Source
“Rheumatoid Arthritis”. American Academy of Orthopaedic Surgeons. 2 April,
Notes
Swelling, pain, and stiffness in the joint, even when it is not being used.
A feeling of warmth around the joint.
Joint deformities and contractures.
Systemic symptoms, including fever, anemia (low red blood cell count) and loss of appetite and energy.
Developing nodules, or lumps, particularly around the elbow.
Foot pain, bunions and hammer toes with long-standing disease.
Source: , 2003
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5. Causes of Rheumatoid Arthritis
The cause of rheumatoid arthritis is not yet known.
It is an autoimmune disease, meaning the body’s natural immune system does not operate as it should.
The immune system attacks healthy joint tissue and causes inflammation and joint damage.
Agent-like viruses or environmental factor may trigger the disease.
Source
“Rheumatoid Arthritis”.Arthritis Foundation. 2 April,
Notes
What Causes It?
The cause of rheumatoid arthritis is not yet known. However, it is known that RA is an autoimmune disease. The body's natural immune system does not operate as it should, resulting in the immune system attacking healthy joint tissue and causing inflammation and subsequent joint damage.
Researchers suspect that agent-like viruses may trigger RA in some people who have an inherited tendency for the disease. Many people with RA have a certain genetic marker called HLA-DR4. Researchers know that there are other genes that influence the development of RA.
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6. Possible Effects of Rheumatoid Arthritis
Muscle weakness and loss of muscle mass.
Heart and lung complications
Neurologic symptoms
Inflammation of the eye
Sjogren’s syndrome
Felty’s syndrome
Osteoporosis
Source
“Rheumatoid Arthritis”.Best Practice of Medicine. 2 April,
Notes
Possible effects of rheumatoid arthritis
Muscle weakness and loss of muscle mass may occur early in the course of rheumatoid arthritis and most commonly occur around inflamed joints.
Heart and lung complications can result from inflammation of the tissue surrounding the heart and lung and the lung itself.
Neurologic symptoms can result from inflammation of the spine and the resulting instability of the upper spine, or from trapping of nerves by inflamed tissues (for example, carpal tunnel syndrome), or due to nerve damage from vessel inflammation.
Inflammation of the eye occurs in less than 1% of people with rheumatoid arthritis.
Sjogren’s syndrome can occur in people with rheumatoid arthritis. This autoimmune disease is characterized by dryness of the mucous membranes, especially the membranes of the eyes and mouth.
Felty’s syndrome can occur in people with rheumatoid arthritis and is characterized by enlargement of the spleen and a decreased number of immune cells that help to fight off infections.
Osteoporosis is a condition characterized by thinning of the bones. This condition can occur in people with rheumatoid arthritis as a result of inflammation and decreased physical activity, and is worsened by steroid treatment.
Source: , 2003
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7. Diagnosis of Rheumatoid Arthritis
Important to diagnose disease early to prevent damage
Medical History
Physical examination, specifically looking for:
Swelling and warmth around the joint.
Painful motion
Lumps under the skin
Joint deformities
X-rays
Blood tests
May reveal an antibody called rheumatoid factor that is an indicator of the disease.
Source
“Rheumatoid Arthritis”. American Academy of Orthopaedic Surgeons. 2 April,
Notes
Diagnosing rheumatoid arthritis
To diagnose RA, your physician will take a medical history and perform a physical examination. Some of the conditions your doctor looks for include swelling and warmth around the joint, painful motion, lumps under the skin, joint deformities and joint contractures (inability to fully stretch or bend the joint).
Diagnostic tests include blood tests and X-rays. The blood test may reveal an antibody called rheumatoid factor that is an indicator of RA, and the X-ray can help show the progression of the disease.
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8. Non-Surgical Treatment Options for Rheumatoid Arthritis
Medications
Symptomatic medications (Tylenol® Arthritis Pain ,NSAIDS, aspirin, corticosteroids) help reduce joint pain, stiffness and swelling.
Disease-modifying antirheumatic drugs (DMARDS- methotrexate, sulfasalazine, gold therapy) modify the course of the disease.
Source
“Rheumatoid Arthritis”.Arthritis Foundation. 2 April,
Notes
Treatment Options
Highly effective drug treatments exist for rheumatoid arthritis. Early treatment is critical. Current treatment methods focus on relieving pain, reducing inflammation, stopping or slowing joint damage, and improving patient function and well-being. Medications can be divided into two groups
Symptomatic medications, such as NSAIDs and aspirin, analgesics, and corticosteroids, help reduce joint pain, stiffness and swelling. These drugs may be used in combination.
Disease-modifying antirheumatic drugs (DMARDs) include low doses of methotrexate, leflunomide, D-Penicillamine, sulfasalazine, gold therapy, minocycline, azathioprine, hydroxychloroquine (and other antimalarials), cyclosporine and biologic agents.
Source: , 2003
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9. Non-Surgical Treatment Options for Rheumatoid Arthritis
Exercise
Develop a program that helps strengthen joints without stressing them.
Helps joints retain or gain flexibility.
Speak to your doctor about an exercise program that works for you.
Physical and Occupational therapy
Joint Protection
Assistive devices
Source
“Rheumatoid Arthritis”.Arthritis Foundation. 2 April,
Notes
In addition, treatment most often involves some combination of exercise, rest, joint protection, and physical and occupational therapy. Surgery is available for joints that are damaged and painful. A balance of rest and exercise can help conserve energy and maintain range of motion and use of the joints.
Source: , 2003
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10. Surgical Treatment Options for Rheumatoid Arthritis
May consider surgery if non-surgical options do not offer relief to pain.
Surgery is dependent on several factors:
Age
Activity level
Condition of affected joint
Extent to which the disease has progressed
Source
“Osteoarthritis”. American Academy of Orthopaedic Surgeons. 2 April,
Notes
Surgery
If early treatments do not stop the pain, the doctor may consider surgery to treat advanced osteoarthritis. It depends upon your age and activity level, the condition of the affected joint, and the extent to which osteoarthritis has progressed. Surgical options for osteoarthritis include arthroscopy, joint fusion and joint replacement.
Source: , 2003
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11. Surgical Treatment Options for Rheumatoid Arthritis
Joint Replacement Surgery
To restore mobility of the joint
Joint Fusion (applies to the hand and ankle)
Eliminates the joint by binding together the ends of the bones, which limits movement of the joints.
Synovectomy
Removal of diseased tissue from the joint
Source
Dynomed, Inc. “What is Rheumatoid Arthritis”. DePuy Orthopaedics, Inc. 2 April,
Notes
In some cases, surgery may be necessary. Surgery, such as joint replacement, is considered when you and your doctor have concluded that previous treatments for pain and mobility have been unsuccessful and your quality of life is suffering. In addition to joint replacement surgery, other types of surgery include the reconstruction or fusion of a joint and the removal of diseased tissue from the joint (synovectomy).
Source: , 2003
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12. Questions?

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