Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a long-term disease that leads to inflammation of the joints and surrounding tissues. It can also affect other organs.

Causes, incidence, and risk factors

The cause of RA is unknown. It is an autoimmune disease, which means the body's immune system mistakenly attacks healthy tissue.

RA can occur at any age, but is more common in middle age. Women get RA more often than men.

Infection, genes, and hormone changes may be linked to the disease.

Symptoms

RA usually affects joints on both sides of the body equally. Wrists, fingers, knees, feet, and ankles are the most commonly affected.

The disease often begins slowly, usually with only minor joint pain, stiffness, and fatigue.

Joint symptoms may include:

Morning stiffness, which lasts more than 1 hour, is common. Joints may feel warm, tender, and stiff when not used for an hour.

Joint pain is often felt on the same joint on both sides of the body.

Over time, joints may lose their range of motion and may become deformed.

Other symptoms include:

Chest pain when taking a breath (pleurisy)

Dry eyes and mouth (Sjogren syndrome)

Eye burning, itching, and discharge

Nodules under the skin (usually a sign of more severe disease)

Numbness, tingling, or burning in the hands and feet

Sleep difficulties

Signs and tests

There is no test that can determine for sure whether you have RA. Most patients with RA will have some abnormal test results, although for some patients, all tests will be normal.

Two lab tests that often help in the diagnosis are:

Rheumatoid factor test

Anti-CCP antibody test

Other tests that may be done include:

Complete blood count

C-reactive protein

Erythrocyte sedimentation rate

Joint ultrasound or MRI

Joint x-rays

Synovial fluid analysis

RA usually requires lifelong treatment, including medications, physical therapy, exercise, education, and possibly surgery. Early, aggressive treatment for RA can delay joint destruction.